relaxing-head-massage-stress-0613136Many people have problems with daily life that begin in the brain. There are many ways this can occur. High levels of stress over time can cause problems with sleep, energy, and mood. A mild traumatic brain injury from a car accident or sports injury may cause difficulty with memory and attention span, and may induce depression. Exposure to chemicals such as those used in chemotherapy can cause problems with mental clarity, leading to a condition referred to as “chemo brain.” Problems with focus, concentration, and attention can be related to a variety of psychiatric diagnoses or sleep deprivation. Is taking medication always the answer?

The Low Energy Neurofeedback System (LENS) was developed in the early 1990s by Len Ochs, PhD, a northern California psychologist. LENS was created as an alternative to medication for brain-based problems and is often used along with psychotherapy. LENS is a computer-based software program that is connected to an EEG box, which measures brainwaves. LENS directly stimulates biochemical changes that are thought to help the brain regulate itself.

The brain is both a biochemical and a bioelectrical system. Medication works on the chemical system, while LENS works on the electrical system. We might think of LENS helping the brain to reboot, like a computer that is no longer functioning optimally. LENS is just as safe and effective as traditional neurofeedback, and works much more quickly, saving both time and money.

Process of Treatment

The treatment itself consists of sitting quietly in a comfortable chair with your eyes gently closed, while the neurofeedback practitioner applies a tiny electrode with conductive paste to your scalp to both measure the brainwave activity and to deliver treatment. It is a completely painless and noninvasive procedure and most find it very relaxing.

Treatment consists of invisible radio frequency waves that are 4,000 times weaker than what your brain is exposed to each time you hold a cellular phone to your head. Not only is the feedback signal incredibly weak, but the length of exposure to it is extremely short. The duration of actual feedback during a typical LENS session is from one second to one minute per site on the head. It might seem impossible that a signal so weak could do anything at all, but it is effective because the brain can respond to the low-energy signal, whereas it would react and defend against a stronger one.

Neurofeedback clinicians have noticed a strong connection between excessive activity in the EEG, particularly in the slower brainwaves, and difficulties with mood, energy, focus, and mental clarity. Trauma and stress tend to cause EEG suppression, in which the brain protects itself from overload and seizure activity by reducing activity, which in turn limits functioning. In this case, the person doesn’t have the full range of emotions, thoughts and abilities they once had. LENS helps to normalize both excess activity and suppression in the EEG, and people feel better and are able to do more of what they want. Most people who receive LENS treatment report feeling more calm, relaxed, and in control of themselves.

Who Can Benefit from LENS?

We all know individuals who are rigid and inflexible, who are stuck in patterns of thinking and feeling that make them miserable, and yet they just can’t seem to change. Some people struggle because they seem to be perpetually stuck in overdrive — unable to wind down at the end of the day, or even to sit still for very long without excessive fidgeting, foot tapping, knuckle cracking, or frequent smoking breaks. Other people seem to be perpetually shut down emotionally and physically, with a sad, downcast appearance, low energy, and minimal interaction with others.

These patterns of thinking, feeling, and behaving are both psychological and physiological. Releasing suppression and reducing excess activity in the brain allows the person to begin to feel that change is possible, so they can begin to make new choices and form new habits. Psychotherapy combined with LENS neurofeedback treatment is optimal in these cases. LENS helps make the brain more flexible and therapy provides the support and coaching for how to make changes and develop new patterns in how we deal with our thoughts and emotions.

One woman I worked with, “Linda,” a middle-aged attorney, had suffered a mild traumatic brain injury ten years ago during a car accident. Her doctors told her, “this is as good as it’s going to get” when she complained of memory problems, headaches, insomnia, and the feeling that her brain “just didn’t work right anymore.” Since then, she was forced to give up her law practice because of these limitations. Her self-esteem and relationships suffered, leading to depression and a feeling of hopelessness about the future.

Linda began to respond to LENS within four or five sessions. Over the course of the four months I worked with her, I saw her twice weekly and each time we met, I noted and she reported improvements. She became giddy when she suddenly realized she could remember words that she had not been able to think of in over a decade without effort. As her limitations were eliminated, her mood brightened as well.

When I first met Linda she presented as someone who had given up and was just going through the motions, appearing disheveled, with dirty hair and stained and wrinkled clothing. She arrived smiling on the day of our final LENS session, her hair and nails freshly done, wearing a bright and flattering dress. As she left, she tearfully thanked me for “giving me my life back.” She had already announced to friends and family she was reopening her law practice and was open for new referrals.

GoodTherapy | How to Effectively Approach Your Partner About Relationship IssuesFor couples to communicate effectively and be able to address issues together, the partners need to focus on their respective roles and responsibilities as the listening or the talking partner.

In my GoodTherapy.org article published last month, I wrote about the responsibilities of the listening partner to ensure effective communication. In this article, I will be discussing the talking partner‘s responsibilities.

As the talking partner, or initiator, you have several options in addressing issues. One is to attack your partner with a list of complaints in a way that shows you don’t believe that anything will change. If this is your choice, your partner is most likely going to defend him/herself by returning fire with a similar list of complaints or shutting down emotionally to avoid further critique and escalating conflict. As you probably have experienced, attacking your partner is not conductive to the two of you achieving a real understanding of each other’s differences.

When couples run into a pattern of attacking and/or avoiding behavior, they are reacting emotionally to each other’s complaints and critiques. Partners often have mixed feelings of anger and hurt. Furthermore, they most likely feel disrespected and mistreated by the other partner while they behave disrespectfully in turn. In this kind of vicious cycle, there is little goodwill, understanding of each other’s thoughts and feelings, or willingness to discuss different perspectives or points of view.

I suggest that you look at another option: refusing to react emotionally, taking a proactive stance, and preparing yourself before initiating a conversation with your partner.

Below are questions to ask yourself before you initiate a conversation with your partner:

Here are a few more points to consider before you sit down with your partner for a conversation about what is important to you:

Basically, how do you want to talk about your issue? Write down your points to keep your focus. Choose an appropriate time and place to present your idea in a new and more effective way. Make sure you ask your partner when a good time is for him/her to start. Also, make sure to tell your partner that you want him/her to be the initiator at a later time, and that you are willing to actively listen to what your partner has to say.

Practicing initiating a conversation about an important topic can improve your ability to communicate effectively with your partner.

GoodTherapy | Off to College: Parental Separation AnxietyCome September, many young people will be leaving home to go away to college. Students and parents are excited about this new journey. But in addition to the excitement, there is often anxiety about moving out of the comfort zone of home and family. While the focus is often on the separation anxiety the student experiences at this milestone, too often we neglect the parents’ separation anxiety.

From watchfulness to surveillance, parents retain a varying degree of control over their high-school-aged children. But when a child goes off to college, the ability to know what is going on in that child’s life depends on the child’s willingness to communicate and share information. Since it is developmentally appropriate for college-aged children to be separating and individuating from their parents, we can expect that many children will share less than parents might be hoping to learn. Not knowing, in areas where there was previous information, makes parents more anxious.

Parents express many different worries about how their children will manage when the parent is no longer so present in their lives. Anxieties may be about drugs and alcohol, or there are concerns about social and academic problems. Parents with children who may already be dealing with emotional issues, eating disorders, or learning disabilities can feel especially anxious.

It is to be expected that a parent would worry about how their child will manage on their own in college. This is appropriate and shouldn’t be confused with a parent’s separation anxiety. When a parent feels the need to contact the child repeatedly, can’t sleep, can’t stop thinking and wondering how the child might be feeling or what the child is doing, the parent may be experiencing separation anxiety. When we think of the child’s separation anxiety we understand it to be about the feeling that “I won’t be alright without my attachment to my parent.” For the parent, it is much the same: “I won’t be alright without my attachment to my child.” Parents experience their anxiety as being about the worry “Is my child going to be okay?” But what they often fail to be aware of is that they may be even more anxious (consciously or unconsciously) about their own well-being. They wonder, “Am I going to be okay?”

Learning to Detach and Individualize

In my therapy practice, I have had the opportunity to work with many parents who have struggled with the separation and individuation of their children. One father, “Seth,” began therapy when his daughter, “Kristin,” was applying to college. He spent many of his sessions talking about Kristin and her college application process. He was very troubled about Kristin keeping him out of the decision making.

Sadly, with tears in his eyes, Seth told me, “She comes home and closes her door and goes on that computer and researches where she wants to go. Her mom and I ask her about her choices, we tell her we need to be part of the process; we remind her that we will be paying a good part of the tuition. She just gets irritated and says she wants to do this on her own and she’ll let us know what she decides.”

Recently, Seth came into my office for his therapy session looking very distressed. He immediately said, “I can’t believe that girl. All of her college acceptances have come in and she has decided to leave New York and go to school in Arizona. That’s much too far away. We’ll never see her! I told her she couldn’t go and she got so mad. She started screaming at us. She said she hated us, that we were terrible parents and never let her have what she wants! She was so mean!”

Seth started to cry softly and, almost in a whisper, said, “I’m so scared. I love her so much, I can’t stand this. It feels like we’ve lost her forever. She’ll never come home. If I don’t agree to pay, she said she would pay herself. She did get good financial aid from them and I don’t think I can play the money card. What am I going to do?”

I asked Seth, “What makes you think Kristin is lost to you forever?”

Seth answered, “We used to be so close when she was younger. She was daddy’s little girl. Her mom worked more than I did and I took her to soccer, to swimming; I helped her with her homework every day. She would tell me about everything — even the boys she had crushes on! Then in her sophomore year of High School, she got more secretive. She started going out with Jeremy and was becoming more social. I could understand that she needed some space from me. My wife and I used to talk about how grown up she was getting. We started to check what she was doing and who she was talking to on her cell phone and computer. There are a lot of scary possibilities out there. She never found out we were keeping tabs on her, but she started to become easily irritated and annoyed around us. She would get on my wife’s case about the food she was cooking and she gets annoyed with me when I ask her about almost anything.”

Seth began to sob, “I can’t eat, can’t sleep. What will I do without her? She is my only child. So much of how I think about myself has to do with my being a father. If I lose her, can I still be a father? What kind of a father could I be without my daughter?”

I reminded Seth that we had been talking about how it made him anxious to think of his daughter having a life so separate and different from his. A lawyer, Seth had followed his father into the law and joined his father’s practice after completing law school. After he married and Kristin was born, he moved into an apartment in the same building as his parents. He understood that his model of parent-child relationships was a reflection of his own experience.

Seth acknowledged what we had been discussing: “I know I grew up very close to my parents, especially my father. I would never talk to him the way Kristin talks to me. I always respected him and needed him for guidance and that gave me such confidence and comfort. It’s not like I thought Kristin had to become a lawyer, but I did hope she might. But she has no interest in it. She wants to major in art, which is fine, but I really don’t get what her art is about. She makes these things out of paper and wood. I try to act interested, but, really, where is that going to get her? How will she make anything of herself? How can I get her to pay attention to what I think? I’m her father.”

Separation Is Not Rejection

Seth’s struggle illustrates many of the issues parents have to contend with as they try to become less anxious about their children differentiating from them. Seeing one’s child as different, as having a separate self with separate desires and ideals, can give a parent the feeling of being rejected. When parents have this experience it is essential to be clear that difference does not signify a child’s rejection. What keeps parent and child attached is not sameness. Sameness can often give parent and child the feeling of closeness, but a very different kind of attachment occurs when there are two separate, different people who are connected by the feelings they have for each other.

For the parent who has felt this sameness with their child but now recognizes that their child is differentiating, there can be painful and frightening anxiety as they try to figure out how to understand and relate to this separate differentiated person. For parents who have not differentiated from their own parents, this can be especially difficult.

Seth is beginning to consider that he can come to know and appreciate his daughter with all her differences. As he begins to relax with the belief that he can know and love this separate person, he is becoming aware how scared he has been that maybe she wouldn’t continue to love him. Seth is only one example of a parent struggling with separation anxiety. One reason I believe Seth is less anxious now than when we began our work is that he has been able to identify that he is feeling separation anxiety.

Many parents who are worried when their children go off to college, are not aware that they are experiencing an emotion that is not simply based on the practical worries of safety or performance or the well being of their children. They have not recognized that they have been afraid that their children would move away from them emotionally, become different in a way to make their attachment feel less close and loving. Realizing this, thinking about separation and individuation as a developmental necessity, not a personal affront or wrenching loss, can help many parents resolve much of their anxious feelings.

Contextual information surrounding memories is crucial to memory encoding, storage, and retrieval. When a person experiences an event that is marked by vivid emotional reactions, they often are able to remember specific contextual facts related to that event. For example, a particularly joyous moment could be recalled with the exact details of where a person was when it happened and exactly when the moment occurred in life. However, this source discrimination of being able to isolate when and where appears to be diminished in people with attention deficit hyperactivity (ADHD).

According to a recent study by Anselm B.M. Fuermaier of the Department of Clinical and Developmental Neuropsychology at the University of Groningen in the Netherlands, people with ADHD show deficits in some areas of memory processing, but not in others. Fuermaier used a word paradigm to test memory induction, storage, and retrieval in a sample of 77 participants, 37 of whom had ADHD. The participants were assessed for memory encoding, memory retention, and memory recall with source discrimination.

Fuermaier discovered that although memory encoding, learning of new material, and memory recall or retrieval of information were equal between the ADHD and non-ADHD participants, source discrimination was not. Specifically, the participants with ADHD had much lower levels of source discrimination than the controls. In other words, they were less able to describe when and where a prior autobiographical event had occurred and were unclear about the context of their memories.

This finding is extremely relevant, as it shows that people with ADHD have impairment attaching contextual meaning to memories. Fuermaier said, “Inefficient source discrimination in adults with ADHD can affect daily functioning by limiting biographic awareness and disturbing general cognitive processes.” Identifying these deficits and empowering individuals with ADHD by teaching them effective memory retrieval techniques could improve overall functioning and increase well-being in all domains of life.

Reference:
Fuermaier, A.B.M., Tucha, L., Koerts, J., Aschenbrenner, S., Weisbrod, M., et al. (2013). Source Discrimination in adults with attention deficit hyperactivity disorder. PLoS ONE 8(5): e65134. doi:10.1371/journal.pone.0065134

AdobeStock 633710496We often hear the term “narcissist,” but what does it mean? From my vantage point as a psychotherapist, I work with many individuals who are leaving and healing from relationships, especially romantic ones, with people who are narcissists. When I first heard the term narcissist as a graduate student, I had a hard time labeling someone with such a label. I pride myself on being a strengths-focused therapist, in direct opposition of any of such disempowering diagnostic nomenclature.

However, as time progressed, I found in my own therapy practice that, indeed, there exist some individuals on this planet with narcissistic challenges. My clients educated me about the aftermath of what it is to heal from narcissistic abuse. I feel I owe it to the people I work with in therapy, and others who may be in similar circumstances, to assist with educating the public about narcissistic abuse, so that people can be informed and aware of how to protect themselves in the event they encounter people with narcissistic traits.

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The following is an attempt at a primer on such individuals. For further study, please refer to the resources listed at the end of the article, as the subject is quite vast.

Identifying Individuals with Narcissism

So just what traits does someone with narcissism have, and what does that person look like in the early stages of dating? Studies suggest that 1% of the general population (2-16% of psychiatric population) has narcissistic personality, while an even greater number exhibit typical traits of narcissism (Brown, 2013). In addition, although 75% of people with narcissism are found to be male, women can also be narcissists.

Narcissism is defined as: excessive sense of self-importance over and above the needs of others; grandiosity; arrogance; absence of ability to empathize and experience reciprocity in relationships; intense need for admiration/attention to fill very low self-esteem; impaired relationships resulting in parasitic/predatory behaviors designed to fill one’s self-esteem in the form of narcissistic supply (DSM-IV).

One could wonder, then, how someone would find such an individual, someone who embodies these characteristics, attractive. Well, studies show (Brown, 2013) that people with narcissism market themselves in attractive, deceptive packages. They may present with a swagger, intense eye contact, false bravado/charm, knock-your-socks-off seduction (often learned by neurolinguistic programming (NLP) programs or online seduction programs), swift pacing of rushing the relationship into commitment/cohabitation/marriage/business partnership, promising a future together (which is later discovered to be a lie), intense sexual chemistry, love-bombing (repetitive texting, emailing, phone calls), or romancing the target excessively (flowers, etc).

People with narcissistic traits are known for targeting intelligent, self-sufficient, empathic individuals as partners. They tend to lack core identity (Brown, 2013), and need narcissistic supply to fill their empty psyches. Narcissistic supply comes mostly in the form of adulation, adoration, and attention, but any sort of feedback allows the individual with narcissistic qualities to feel alive (including negative attention). These individuals feel a sense of challenge in targeting highly successful, attractive individuals who may already be in other relationships and/or who express a sense of vulnerability (i.e. having grief or depression, or recently getting out of a relationship).

Characteristics of the Relationship

The literature on malignant narcissism is extensive, yet many are not informed about the dangers of being involved with someone whose character or actions tend toward narcissism. I find that clients who were entangled in relationships with such individuals have more healing to do from breaks in these relationships than if they had been in relationships with healthy individuals, because often these clients are manifesting symptoms of posttraumatic stress.

Not only are they grieving the loss of the relationship, but they are also processing the unreality of a “fake relationship.” Furthermore, often psychological abuse (and sometimes physical and sexual abuse) has permeated the relationship. In order to heal, psychotherapy must focus on grief work and trauma recovery, in addition to understanding the elements of the toxic relationship, so that patterns are not repeated in the future.

Once the initial honeymoon wears off, partners of people with narcissistic traits go from feeling high on a pedestal (much like being on cocaine) to feeling devalued, discarded, and figuratively knocked off the pedestal. Their partners have successfully seduced and hooked them into relationships.

But suddenly, the individual with narcissism begins to reveal traits of lying, future-faking, and Dr. Jekyl /Mr. Hyde Personality. He or she may vanish for hours or days on end, or gaslight (confuses the reality of) a partner. This person becomes emotionally abusive and detaches from the partner, extracting narcissistic supply in the process.

The partner, then, is dropped/discarded, coming to the sudden and shocking realization that the other, the partner to has narcissistic qualities, is not capable of true intimacy/love, and really exhibits a limited capacity for emotional connectedness/bonding (Brown, 2013). The partner who has exhibited narcissistic personality traits, who was once a knight in shining armor, is now a mere fantasy, because he or she acted through mind control and brainwashing (Brown, 2013).

To Protect Yourself

So how does one avoid encountering someone with narcissism? I would suggest being particularly cautious with the pacing of dating. If you’re using a dating website, exercise extreme caution when meeting up with a dating partner for the first several dates until you feel you know the individual (i.e. meet in a public place).
If the dating partner attempts to rush the relationship, that is a red flag. An individual who respects your boundaries will work with you to slowly progress the relationship at a pace that is mutually agreed upon. Just because initially there is a highly seductive “zing” quality to the attraction does not mean that the dating partner is healthy. To protect yourself from someone who may end up behaving out of narcissism, it is best to allow the connection to unfold slowly and observe to see if actions and words are matching up.

Sexual chemistry is not the same thing as healthy bonding and attachment. A healthy person will want to get to know your personality, dreams, and interests, and slowly evolve the relationship. An individual with narcissistic tendencies may also want to know all about you, but then may fake being your soul mate by rushing you into consenting to a relationship/marriage/cohabitation/business arrangement (Hotchkiss, 2010).

If you have encountered an individual who seems to display these qualities, or are considering leaving a relationship with a similar person, it is in your best interests to get yourself out of the relationship as quickly as possible. People with narcissistic characteristics may be prone to causing harm by invading personal boundaries, lying about future possibilities in relationships, engaging in abuse, and exhibiting no empathy or remorse for emotional harm they have done.

Consult a licensed psychotherapist who is trained in narcissistic abuse recovery in addition to locating a qualified support group to help you through this time. You will recover. You will heal. But, it will take time and the assistance of qualified professionals who understand what you have endured and how to help you to reclaim your self-esteem.

Resources:

  1. Saferelationshipsmagazine.com:  Sandra A. Brown, MA’s website and resources related to abuse recovery from unhealthy relationships
  2. Lisaescott.com: The Path Forward online forum and support network for survivors of narcissistic abuse
  3. Baggagereclaim.com: A website dedicated to individuals healing from relationships with emotionally-unavailable people (including narcissists)
  4. Outofthefog.com: A website with support and resources for people moving forward from abusive relationships
  5. Help! I am in Love with a Narcissist by Steven Carter and Julia Sokol
  6. Women Who Love Psychopaths: Inside the Relationships of Inevitable Harm with Psychopaths, Sociopaths and Narcissists by Sandra L. Brown
  7. Without Conscience: The Disturbing World of Psychopaths Among Us by Robert D. Hare
  8. Emotional Vampires: Dealing With People Who Drain You Dry by Albert J. Bernstein, PhD
  9. Emotional Blackmail: When People in Your Life use Fear, Obligation and Guilt to Manipulate You by Susan Forward
  10. Why is it Always About You? The Seven Deadly Sins of Narcissism by Sandy HotchKiss, LCSW
  11. The Wizard of Oz and Other Narcissists: Coping with the One-Way Relationship in Work, Love and Family by Eleanor Payson, MSW
  12. Narcissistic Lovers: How to Cope, Recover, and Move On by Cythnia Zayn and Kevin Dibble
  13. Splitting: Protecting Yourself While Divorcing Someone with Borderline or Narcissistic Personality Disorder by Bill Eddy, LCSW
  14. Stop Walking On Eggshells: Taking Your Life Back When Someone You Love Has Borderline Personality Disorder by Paul Mason, MS
  15. Malignant Self-Love: Narcissism Revisited by Sam Vaknin
  16. Freeing Yourself from the Narcissist in Your Life: At Home, At Work, With Friends by Linda Martinez-Lewi, PhD

secondary-trauma-coping-loved-ones-0605137Traumatic events usually occur without notice and result in people trying to deal with the aftereffects long after the event is over. Recent events, such as the Boston Marathon bombings, bring to light how traumatic events can create effects for long periods of time. Traumatic events can result in the development of posttraumatic stress (PTSD), which is a prevalent and serious mental health issue.

According to the National Institute for Mental Health, 26.2% of the adult American population will meet the criteria for a diagnosis of PTSD at some point in their lifetime. PTSD can severely impact a person’s ability to function in day-to-day life and interactions and relationships with loved ones. In my practice, I have noticed that relationships can become strained or distant, or even end due to the stress caused by PTSD.

Just as it is important for the person who experienced the trauma to address his or her symptoms, it is also important for their loved ones. Loved ones often report feeling helpless in assisting the person with PTSD to feel better. So what can loved ones do to help those who have PTSD in their recovery?

Practice good self-care. When a loved one has been traumatized, the stress can take a toll on that person’s entire support network. Making sure you are practicing good self–care habits such as eating well, getting enough sleep and rest, and continuing to engage in activities you find pleasurable can be very helpful in addressing the stress that can come with a traumatic event.

Offer your support, but don’t push the person affected with PTSD to describe or talk about the event that traumatized them if they do not want to. Many people affected with PTSD do not wish to “relive” the trauma by frequently talking about it or by going into detail. Sometimes well-meaning loved ones will push them to talk about the trauma without realizing that doing so can do more harm than good. Loved ones may feel offended or rejected when the traumatized individual does not want to talk about the incident. Know that this is nothing to personalize. You can be there as a supportive person to listen when they want to talk, without trying to “fix” what they are going through. Simply saying something like, “It sounds like that was really hard” or just letting them know you are happy to be a listener can be validating and can help the person to feel supported as they work through their trauma.

Encourage the person affected with PTSD to seek professional help. PTSD is a serious mental health issue that requires professional assistance to treat and overcome. There are many treatment modalities that have been successful in the treatment of PTSD. It is possible for a person with PTSD to get to the point where the traumatic event has little or no disturbance associated with it. There is much hope for overcoming PTSD, but it is much more likely for someone to overcome PTSD with professional help. Support groups can also be helpful for people suffering from PTSD as it gives them additional care in their recovery.

Get support and treatment for yourself. Having someone you love go through a traumatic event and supporting him or her as they recover can result in secondary trauma. Secondary trauma is defined by Figley (1995) as “the stress resulting from helping or wanting to help a traumatized or suffering person.” The signs of secondary trauma can include similar symptoms to PTSD, including (but not limited to) having overwhelming emotions, exhaustion, having thoughts that are intrusive and disturbing, difficulty concentrating, nightmares, and detachment from others. These are symptoms a therapist and support group can help you overcome. Be aware of your own emotions and mental health in order to identify the signs early.

Above all, don’t go through such a difficult time alone. There is support and an abundance of resources available to help people with PTSD and their caregivers overcome trauma and secondary trauma.

References:

  1. Figley, C.R. (Ed.) (1995). Compassion fatigue: Secondary traumatic stress disorders from treating the traumatized. New York: Brunner/Mazel, p.7.
  2. National Institute of Mental Health. Post-traumatic stress disorder among adults. NIMH. Retrieved May 28, 2013. From nimh.nih.gov/statistics/1ad_ptsd_adult.shtml.

Studies on depression have shown that negative affect is a strong risk factor for depressive symptoms. Rumination, the process of thinking about negative events and distressing situations, can increase negative affect and make people more vulnerable to depressive episodes.

Neil P. Jones of the Western Psychiatric Institute and Clinic at the University of Pittsburgh in Pennsylvania wanted to add to the existing research on depression and rumination by looking at how goal failure, an event that can lead to negative emotions, influences affect. In his study, Jones examined the emotional reactions of 93 college students after they completed an exercise that required they write about their past failures related to prevention and promotion goals.

Promotion goals are hopes, dreams, and desires while prevention goals are classified as more obligatory and necessary goals pertaining to safety and security. Jones theorized that chronic failure to achieve the goals would lead to higher levels of rumination and increased depression and even anxiety in the participants. The results provided partial support for Jones’ theory.

First, the participants who wrote about chronic promotion goal failure reported higher levels of dejection. Surprisingly, even though they did not perceive themselves failing chronically at prevention goals, they still felt dejected when they wrote about any prevention goals they did not achieve. In other words, negative associations with promotion goals created an overall sense of dejection which led directly to increased rumination.

Jones found no association between goal failure and rumination, except when dejection was present. This was particularly interesting and suggests that there may be a protective mechanism at play, allowing some individuals who are exposed to goal failure to regulate their emotional reactions to the exposure so that they do not feel dejected and engage in negative rumination.

Jones believes these results extend existing research on the relationship between goal failure, affect and depressive symptoms. “Our findings are also consistent with our previous work demonstrating that dispositional tendencies to ruminate combined with chronic perceived promotion goal failure are associated with increased depressive symptoms,” added Jones.

Reference:
Jones, Neil P., et al. (2013). Cognitive Processes in Response to Goal Failure: A Study of Ruminative Thought and its Affective Consequences. Journal of Social and Clinical Psychology 32.5 (2013): 482-503. ProQuest. Web.

Woman reading in beach chairAs a sex therapist, my professional library is often scoured and delighted in by colleagues and clients alike. The books on my shelf boast attention-grabbing titles and alluring content. As the summer heat approaches, why not read about heating up your sex and intimate life? Below is an authentic peek into what is on my bookshelf, and what I regularly recommend to clients, family, and friends.

The Heart of Desire: Keys to the Pleasures of Love (2012) by Stella Resnick, PhD. Published by Wiley.
A highly user-friendly book exploring the love-lust dilemma through the lens of the latest scientific research. Using everyday language, the author explains how early programming impacts sexual desire in committed partners. This book provides a body-mind program to sharpen the reader’s skills for fulfilling sexual pleasure. Topic covered include: “What Dampens Desire,” “Sexual Health and the Body,” and “The Nuances of Sexual Pleasure.” It is a must-have for your library.

Resurrecting Sex (2002) by David Schnarch, Ph.D. Published by Harper.
This book will assist you in creating erotic, meaningful sex whether you have had long-term difficulties, or just find yourself bored. For men and women alike, this is a fantastic self-help book for sexual difficulties. There are very few of us who don’t experience sexual difficulties at some point in our lives and relationships — why not read ahead as preventative care, or a solution to what has you stuck? From desire, to pain, to an elusive orgasm, this book can support you with a solution-focused approach for long term learning and development.

The Good Vibrations Guide to Sex: the Most Complete Sex Manual Ever Written (2002) by Cathy Winks and Anne Semans, Illustrations by Phoebe Gloeckner. Published by Cleis Press.
I can’t say enough about this book; it’s straightforward yet casual, informative yet fun to read. From erotica to technique, communication to anatomy, this book has it all. I find it to be my go-to resource for quick and easy-to-understand information. This book is a great resource for wanting to learn about a specific aspect of sexuality, such as oral sex, to wanting to improve your masturbation experience. This book explores the world of sex toys, fantasies, and sex play. The illustrations are top-notch and educational. Ever wonder what a two-strap harness is? Or where the prostate gland is? These illustrations cover everything you wanted to know, and possibly more. It’s a fun book to explore with someone or on your own.

Pleasure: A Woman’s Guide to Getting the Sex You Want, Need and Deserve (2006) by Hilda Hutcherson. Published by G.P. Putman’s Sons.
For a woman, reading this book is like having a girlfriend telling you what’s what when it comes to orgasms, pleasure, and communicating with your partner about what feels good — not to mention helping you explore new ways and new locations for pleasure to be experienced and expanded upon. Hutcherson’s savvy approach will give ladies a new perspective on their bodies and their bodies’ potentials. This book takes the pressure off of the orgasm as the end goal, and instead provides us much more fulfillment in the journey.

Tantric Sex: the Path to Sexual Bliss (2008) by Kavida Rei. Published by Dorling Kindersley Publishing, Incorporated.
This book ushers readers into understanding and embracing the beauty of tantric sex, while providing space for the reader to explore at their own pace. The book’s back cover explains that it can provide you the opportunity for “deeper self-knowledge, greater intimacy, and genuinely fulfilling relationships.” It also touts the discovery of “mind-blowing sex” — who couldn’t use some of that?! This book is full of beautiful photos to guide the reader into an experience of mindfulness, sacredness, and holistic sensation.

Happy reading and enjoy the results!

(Author’s note: I have no affiliation with the authors and I am in no way compensated by them for my suggestions.)

Mother and daughter coloring with crayonsAt the heart of this therapeutic approach is a focus on human connection, since the underlying theory in reality therapy posits that human relationships are the most vital of the five basic needs we must satisfy to be happy and fulfilled. The remaining four needs include: survival or self preservation, achievement, independence or freedom, and fun.

This approach is founded on the belief that individuals choose many of their behaviors in order to satisfy these needs, which are innate. Therapy provides the opportunity for an exploration of the degree to which a person in therapy’s needs are being met.

A problematic relationship, past or present, is thought to be the major source of a person’s presenting problems. The relationship could be one of many—for example, with one’s significant other, sibling, parent, child, friend, teacher, colleague, or boss. The goal of reality therapy is to support people in identifying the problematic relationship, assist them to evaluate how their behavior may be helping or hurting, and to give them tools to reconnect in a healthy way.

As a school counselor and therapist, I utilize reality therapy concepts both with adults and children and find them exceptionally useful in gathering immediate, vital data about the person. I especially like that reality therapy has an artistic/drawing component that helps people feel less threatened and more able to access and evaluate behaviors and emotions than might be possible using a traditional therapeutic approach.

Discovering One’s ‘Quality World’

Exploration of the person’s quality world provides both clinician and person in therapy valuable information. One’s quality world is unique to each person and is essentially that place inside us that holds a vision (pictures) of all that is most important to us. Among many, the pictures may include our homes, special people, places we hope to visit, hobbies and interests, our religious or spiritual practices. Quality world pictures depict present circumstances and dreams for the future. Quality world pictures may reflect things we presently possess or long for in the future; other pictures may indicate what we have relinquished hope of manifesting (the adult who always wanted to play the violin, go to Paris, learn a language, or have a baby; or the child who wished he could be a better student but has given up).

I have never found an adult or child who was not eager to depict their quality world when invited to do so. I generally describe the quality world as I have above, and I give a few examples of the pictures in my own to help people understand what I am asking of them. The simplest way is for people to use a piece of paper and either draw symbols to represent a specific want, or write a word that represents it. I encourage them to be as creative as they’d like. There is no wrong way to do the exercise.

Living One’s Quality World

In as little as 10 or 15 minutes, the counselor or therapist can learn the most important and desired aspects of the person’s inner world. The counselor or therapist also learns what the person is lacking—for example, the child whose quality world depicts no friends, or no parents. People are invited to talk about their words and symbolic representations and this provokes a rich dialogue and the beginning of a close connection between person in therapy and clinician. It also helps people to reflect on and appreciate what they have, as well as to evaluate their goals, the probability of their success, and the action they are taking to attain them.

What impresses me most about reality therapy is that it is an effective and collaborate approach for multiple environments (schools, businesses, counseling, and therapy). Some of my child clients even go home and use reality therapy concepts they learn with me on mom and dad. It helps people to be accountable and teaches them skills that are empowering and easy to share with others.

GoodTherapy | The Psychology of Online Role-Playing GamesWhile traditional video games typically require only brief periods of investment from players and don’t involve developing a new persona, online role-playing games tend to be much more time-intensive and require a strong emotional investment. These games encourage players to become a character—often one who is very different from a player’s real-life persona—and often have no end point. They can be played for hours, days, or even years, with characters networking with others to develop a virtual world that may feel more comfortable than the real one. The games can prove addictive and may interfere with real-life responsibilities, but they also offer several benefits, with some people finding that they master new skills online.

Adopting a New Persona
The hallmark of a role-playing game is that players adopt personas for their characters rather than playing as one or several pre-established characters. Depending on the game, players may be able to write their character’s life story, choose their character’s specific appearance, and take on a wide variety of personality traits. Some players view this as an opportunity to experience what it’s like to be a completely different person. Men might become women, for example, and young people might choose to be elderly.

This investment in the new persona can, however, be problematic for some players. A player who feels isolated or who is unsatisfied with his or her life might become more invested in the character and the character’s friends than he/she is in real life. Players who spend too much time on the game might abandon their own personal development and friends in favor of developing their characters and making friends for their characters.

Effects on Relationships
A Brigham Young University found that 75% of people involved in a relationship with a role-playing game player wish their partner spent less time playing the game. The intense nature of these games and the fact the time commitment is limitless means relationships can take a hit. Some players may even develop romantic relationships for their characters while playing the game, and these relationships can disturb real-life partnerships.

However, all is not lost when it comes to RPGs and relationships. The same BYU study also found that 76% of couples who played role-playing games together believed that it strengthened their relationship. Working together in this new, mutually experienced environment can make a relationship feel new and fresh, and gives couples a shared pursuit.

Addictive Nature
Role-playing games, like many other behaviors, can become addictive. Successful players generally have to spend a lot of time on the game and may spend hours networking with other players. This time commitment increases the likelihood that a player may become addicted, and the pressure from other players to keep playing the game can make it difficult to pull away.

Benefits of Role-Playing Games
Although many parents are concerned about their children playing RPGs and despite a significant amount of negative press coverage, RPGs also offer some important benefits. These include:

References:

  1. Billieux, J., Chanal, J., Khazaal, Y., Rochat, L., Gay, P., Zullino, D., & Van der Linden, M. (2011). Psychological Predictors of Problematic Involvement in Massively Multiplayer Online Role-Playing Games: Illustration in a Sample of Male Cybercafé Players.Psychopathology, 44(3), 165-171. doi: 10.1159/000322525
  2. Dupuis, E. C., & Ramsey, M. A. (2011). The Relation of Social Support to Depression in Massively Multiplayer Online Role-Playing Games. Journal of Applied Social Psychology, 41(10), 2479-2491. doi: 10.1111/j.1559-1816.2011.00821.x
  3. Feng, J., Spence, I., & Pratt, J. (2007). Playing an Action Video Game Reduces Gender Differences in Spatial Cognition. Psychological Science, 18(10), 850-855. doi: 10.1111/j.1467-9280.2007.01990.x
  4. Online role-playing games hurt marital satisfaction, says BYU study. (n.d.). Brigham Young University. Retrieved from http://news.byu.edu/archive12-feb-mmorpgs.aspx

therapy-dogs-0527137Talk to any pet lover and he or she will tell you that pets make life richer and better. But pets aren’t just a source of fun and an occasional source of extra work. Animals can play important roles in helping people recover from illness, making medical visits less stressful, and relieving social isolation. Although a wide variety of animals have been used in therapeutic settings, therapy dogs are the most popular option, and there’s strong evidence that a therapy dog can make a huge difference in a person’s quality of life.

What Are Therapy Dogs?

A therapy dog is any dog used in a therapeutic setting to improve treatment outcomes. Some are trained to complete specific tasks, while others are just well-behaved dogs. There’s no specific breed, size, or age requirement for a dog to become a therapy dog. Some are raised and specifically trained to provide therapeutic services, while others are just pets visiting a nursing home or rehabilitation center over the weekend.

What Do They Do?

Therapy dogs are hugely diverse and can fill a wide variety of functions. Some visit people living in nursing homes and respite facilities, providing companionship and a brief opportunity to pet an animal. Others work with children in crisis. For example, some child-abuse centers provide a chance for children to talk to therapy dogs, rather than people, about their abuse. Some prisons have established therapeutic pet-ownership programs in which a prisoner cares for an abandoned or unwanted dog or puppy. Some dogs are highly trained and work as seizure-alert dogs for people with epilepsy or as assistance dogs for people with sensory limitations. Dogs also have been used to help war veterans experiencing posttraumatic stress and other issues. These dogs sometimes undergo years of training before they’re placed with an owner.

What Are the Benefits?

Dogs have a soothing effect on people. The simple act of petting a dog can ease symptoms of depression and anxiety. The benefits of therapy dogs are overwhelming, and include:

Can Your Dog Be a Therapy Dog?

There are several organizations that certify dogs as therapy dogs, but not all dogs are certified. Some nursing homes, for example, recruit owners of well-behaved dogs to bring their dogs in a few times a week or month. In most cases, though, your dog will need to pass a temperament test and show no signs of aggression or fear toward people or other animals. Some dogs may need more intense training. For example, therapy dogs that work with children might have to learn how to tolerate being hugged tightly and master the art of not jumping on a rambunctious child.

Guide dogs usually undergo a year or two of training before moving in with a permanent owner. Several organizations recruit families who are willing to put in the time and effort to train a guide dog. However, they have to give up the dog when it’s time for him or her to move in with a permanent owner.

References:

  1. Getting started. (n.d.). Therapy Dogs International. Retrieved from http://www.tdi-dog.org/About.aspx?Page=Getting+Started
  2. Perceptions of the impact of pet therapy on residents/patients and staff in facilities visited by therapy dogs [PDF]. (n.d.). Flanders: Therapy Dogs International.
  3. Walsh, P. G., & Mertin, P. G. (1994). The Training of Pets as Therapy Dogs in a Women’s Prison: A Pilot Study. Anthrozoos: A Multidisciplinary Journal of The Interactions of People & Animals, 7(2), 124-128. doi: 10.2752/089279394787002014
  4. What is a therapy dog? (n.d.). Therapy Dogs of Vermont. Retrieved from http://www.therapydogs.org/index.php?option=com_content

GoodTherapy | When Your Partner Won't Go to Therapy can work wonders in a relationship, helping each partner to see the other’s perspective and empowering a couple to adopt love-affirming habits that meet one another’s needs. Relationship experts and therapists may recommend couples counseling for a broad variety of issues ranging from financial problems to infidelity, and some people view couples counseling as the panacea that will cure an ailing marriage.

If your spouse won’t go to marriage counseling, you might feel betrayed or unwanted, but pushing your spouse into counseling against his or her will can be just as damaging as the problems that led you to therapy in the first place. Instead, it’s best to try to work through the resistance as a couple and, if all else fails, try going by yourself.

Talking About It
If your spouse won’t go to therapy, your feelings of rejection can quickly get in the way of investigating your spouse’s feelings. Rather than assuming you know why he or she won’t go therapy, talk about the issue instead. Some people are concerned that therapy will make their marriage worse, while others feel that therapy is a stigmatizing process. Once you understand the reason your spouse won’t go, you can work through the issue together and decide whether therapy is a wise choice.

Alternatives to Therapy
Although therapy can improve your marriage, it’s not the only thing that works. Talk to your spouse and see if he or she might be willing to try an alternative approach. You might, for example, have a weekly meeting during which you talk about the state of your relationship, each resolve to do a favor for the other every day, take 10 minutes each day to listen to your spouse’s feelings, or spend the money you would spend on therapy on a romantic weekly outing. Spending quality time together and validating one another’s feelings can improve your marriage even without therapy, and are two of the skills many marriage counselors focus on.

When to Worry
There’s a big difference between refusing therapy and refusing to work on the marriage. But if your spouse refuses to make any changes, to talk about issues within your relationship, or to adopt any strategy at all designed to help your marriage, this is a problem. Refusing to make any changes at all and ignoring a spouse’s legitimate needs is a form of emotional abuse. However, it could be that your spouse is feeling down about your marriage or depressed. Whether refusing to work on the marriage is a controlling, manipulative tactic or the product of hopelessness, you can benefit from going to therapy without your spouse.

Going Alone
Marriage isn’t always equal, and there may be times when you or your spouse works harder on the relationship. If you want to improve your marriage, working on yourself—even without your spouse—can be a powerful first step. As you begin to make changes, your spouse’s behavior may also change. And in some cases, your spouse might be so curious about what happens in therapy that he or she feels compelled to go with you. Even if your spouse never goes to therapy, however, going alone can help you deal with the stress of marital problems and, if your spouse refuses to work on these problems, help you figure out your next steps.

References:

  1. Bernstein, E. (2012, March 6). Couples therapy for one: To fix a marriage, some go alone. The Wall Street Journal. Retrieved from http://online.wsj.com/article/SB10001424052970203458604577263303967929424.html
  2. What to do when your spouse won’t go to marriage counseling. (n.d.). Guy Stuff at CCRG. Retrieved from http://www.guystuffcenter.com/2012/03/what-to-do-when-your-spouse-wont-go-to-marriage-counseling/
Important Notice

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