 These are surely trying times. I have been in practice for 25 years and never seen the level of interest in therapy that I see now. Everyone is stressed, isolated, lonely and frustrated. Some folks are scared or worried. And yet access to our usual supports-- churches, synagogues, mosques, neighborhood BBQ’s, family reunions, book clubs, bowling nights, even date nights are on hold or have changed so drastically that they are hardly recognizable. But as humans our need to connect persists even in the face of a pandemic. So what can you do without access to other people and without leaving your house? One answer is in an ancient tradition called Loving-kindness Meditation (often abbreviated LKM or sometimes referred to as “metta” meditation. This tradition originated in the east as part of Buddhism but requires no spiritual beliefs. In Buddhism there is a belief that all life is connected and that all life has value. So LKM was developed to help cultivate a sense of connection and compassion for all. We now know that “loneliness and social isolation can be as damaging to health as smoking 15 cigarettes a day” . So if you are isolated like most of us during COVID-19 you are literally increasing your health risks as much as smoking almost a pack of cigarettes a day! That’s a big change in your health. Everyone who reads my blogs knows that I am a big research nerd. So I would not be recommending this technique if I had not read multiple studies showing it’s benefits. For a brief amount of time (15-20 minutes) you can increase positive emotions and decrease the negative ones , including less depression and less symptoms of illness-- both very helpful in this time of a pandemic! We’ve known for many decades now that there is a direct link between stress and the immune system, (so things like meditation that decrease stress can help improve our bodies ability to fight off invading germs. There is also a link between loneliness or social isolation and the immune system. ”Loneliness can alter immune system cells in a way that increases susceptibility to illness”. And in a time where you can’t get together with friends or family as easily, LKM is a great way to combat loneliness! LKM can also increase our “emotional intelligence”. One aspect of emotional intelligence is the ability to have empathy and compassion for others. According to one author on the subject, “loving-kindness practices strengthen empathic concern: our ability to care about another person and want to help them”. There is a great video embedded in that interview and I recommend watching it during your new now-I-work-from-home schedule… And if decreasing loneliness and feelings of isolation, improving immunity and feelings of empathy towards others and having more positive emotions (and less negative ones) isn’t enough...LKM is also good for your brain! Studies have shown that it increases gray matter (brain cells). Loving-kindness meditation also improves your ability to relax. If you have been feeling stressed by changes due to the pandemic then practicing LMK for even just 10 minutes a day can help your body drop into a more relaxed and healthy state. Remember that your body has only 2 modes-- the stress response (bad if triggered too often or for too long) and the relaxation response. If you can stay in the relaxation part of your nervous system more often it fends off stress-related illnesses and emotional problems like anxiety and depression. And if the pandemic has not been stressing you out then consider this-- practicing LKM makes you less biased towards others. During these times of social change and focus on racial issues this can be an important act of social responsibility for all of us. And if you have been feeling like an unproductive lump during the pandemic and beating yourself up about what you are not getting done, consider this study that showed that LMK decreases self-criticism. So if you have been feeling lonely, isolated, depressed, anxious, self-critical or less tolerant of others during this pandemic I suggest that you try out Loving-kindness Meditation. There are plenty of youtube videos you can experiment with. Another great resource for meditation is psychologist Dr. Seigel’s website, which has not only LKM’s you can stream or download but also lots of other information about mindfulness practices. Remember, it doesn’t take a lot of effort. LKM does not require you to “empty your mind” or even track your thoughts! It can be done in 10 minutes and most people find it very pleasant and relaxing. I hope you will be wiling to give it a try and if you find it beneficial pass this information along to a friend! Wishing you health and peace in these stressful times, Dr. Jordan PS-- If you have found this blog helpful PLEASE help others to find it by tweeting it, posting it on Facebook or other social media platforms. And feel free to leave a comment, I will respond within a few days! And thanks!
0 Comments
 When my son was little he told whoppers. And not just occasionally. At one point it seemed that every other sentence that came out of his mouth was pure fabrication. As a parent I have to admit I was a bit concerned. So I did some research. And felt a lot better... Here's the good and bad news. About half of us lie. A study done in 2009 showed that lying does vary-- some people don't really tell any, some tell a few and some tell many. The good news is that the prolific liars are rare-- about 5% in this study. There are even "mega" liars, who tell 20+ lies per day. These folks are only about 1% of the population and if you hang around them for a hot minute you can quickly figure out who they are. Aside from these Mega Liars one of the biggest predictors of lying is age. Kids under the age of 2 are actually VERY honest. They have not figured out how to lie yet. Teenagers lie about 60% of the time. For most people lying peaks in adolescence. Some professions have more liars than others (business and tech being the top liar-rich professions). But of course those are generalizations so please don't go accusing every VP or techie of lying. One piece of information I found immensely helpful in regards to children lying was understanding more about moral development. Children are not born with an inherent ability to think about morality. So to tell a 4 year old not to lie because "it's not nice and it makes Mommy sad" is NOT developmentally sound. They don't have the moral development to understand that. I found the following chart to be very informative:  So basically if a kid under the age of 8 is lying please don't lecture them about the morality issue. Just help them understand what's in it for them if they are truthful. How lying is going to get them into more trouble and how telling the truth will get them more friends, more accolades or more ice cream. Because that is the level that their brain is capable of understanding things at that point.
Now some of you are probably saying "well, not MY child! When he was just 3 years old he was already taking care of other children's hurt feelings and sharing because he knew it was important to be kind". I hate to break it to you, but your kid only did that when you were watching. Kids know what parents want from them and because parents are necessary for children's survival they will learn how to please parents. Where the rubber meets the road is what your kid does when they think no one is watching. And let me be clear, before the age of 8 they do what is best for THEM, not what you or I would think is moral. And that's OK. That's just part of being a kid with a brain that is not fully cooked yet. So how do we think of adults who lie? Well one way to think about it is that those adults are developmentally stunted. Seriously. They may have grown up in stressful conditions without enough positive investment by good adults and literally they may have stalled in their moral development. That does not mean that we should not hold them accountable, but it may help you have more compassion for their impulse to lie to get out of a scrape. It takes bravery to face the music and bravery, I would argue, can only be learned if you have enough emotional support early on. Another possibility is actually neuroscience. Researchers have found that people who lie a lot have more white matter in their frontal cortex than more honest folks. White matter helps brain connectivity, so that messages can travel at high speeds between different brain areas. This allows a person to think quickly on their feet. So if I ask you where you were last night and you are an average person you may stall, fidget, say "um", "er" and eventually after a second or two cough up a semi-believable lie. But someone with extra white matter in the frontal area of the brain (and also less gray matter, which helps with inhibition) will quickly and without pause churn out a very believable story. We assume that since they did not hesitate it is the truth because for most of us lying on the spot like that is difficult. One study using functional MRI's showed that "liars had 26% more white matter compared with anti-social, non-liars, and 22% more than the controls. Liars also had 14% less grey matter than the controls." The researcher noted that lying is a very complex task that requires the cooperation of different brain regions to be done well. “It’s a bit like being a mind reader. You have to think, 'what does she know about the situation, what does she not know’. You also have to suppress anxious emotions and the automatic impulse to tell the truth." Interestingly "Autistic children, who find it very difficult to lie, develop white matter at a sixth the rate of ordinary children." So their difficulty lying may be due to a lag in developing this white matter. Which leads me to my good/bad conclusion about my son. I decided that he is probably one of these people who has more white matter. For him lying is easier. As a young kid he had not yet had enough experience to realize that lying was ultimately going to get him into trouble. As far as he could tell at the ripe old age of 8 he was getting away with it. Which he was most of the time. So we talked a lot about how even if someone believes you in that moment they may find out about the lie later and it could cause you to lose friends. It took a few years of having these talks and also giving him a 24 "grace period" during which after telling one of his fabulously believable whoppers he could come clean with us with no repercussions. I am not kidding you it was impressive the lies he admitted to. He was GOOD. His lies were smooth, plausible and effortless. I would have never spotted them if he had not later confessed. Which is why I eventually concluded that he has that different brain (he's also great at other tasks that require the coordination of different brain areas). So the way I think of it, some people are wired such that lying is easier and they get caught less often. Which, if you start in childhood, can become an easy habit to keep up into adulthood. At that point it is just second-nature and harder to stop. Again I am not saying that you should give people a pass even if you are holding their brain imaging in your hot-little-hands as they lie to you. But it may help you have more compassion about how they developed that nasty habit to begin with. I would argue that if we all had that increase in white matter and less gray matter we may ALL lie a lot more. Most of us probably don't lie much because, in all honesty, we just aren't that good at it and we don't like getting busted. I am pleased to say that my son no longer lies reflexively. Well, as far as I know. Because believe me, he was darned good at it. But if I do catch him in one, while he still has to face the music, I try to be compassionate and think that it's hard not to use a super-power when you have one. Wishing you health and happiness, Dr. Jordan PS If there is a topic you would like me to blog about please feel free to email me or post a comment here. And if you enjoyed this blog or found it helpful PLEASE post about it on social media. Thanks!  Anxiety disorders are the most common psychiatric illness in the United States. Around 40 million people struggle with anxiety that is at debilitating levels. That's one in five people! So what's going on in anxiety? Basically your sympathetic nervous system, which is designed to help you fight or run from predators (think a bear chasing you in the woods) has gone a bit haywire. Things that should not provoke this response (racing heart, dilated pupils, cold sweat, massive amounts of adrenaline in your bloodstream) have triggered this response. Which feels pretty terrible. Some people experience intense anxiety only occasionally, like before giving a talk in front of an audience, but other people experience anxiety on a daily basis. Regardless of how much anxiety you have or when it comes on the treatments are essentially the same (except for simple phobias like fear of snakes or fear of flying, which really needs exposure therapy). You can reduce your overall anxiety by following any of these tips:
As always wishing you health and happiness, Dr. Jordan PS If you have a topic you would like to see addressed in a blog feel free to email me. Or if you have comments or questions about things I have posted. To subscribe to my blog and have it emailed directly to you just fill out the form below. I NEVER give your email to anyone else and the only thing you will get is the blog, which is about once/month. PPS If you have enjoyed this blog or found it helpful please Tweet about it or Like it on Facebook so that others can find it! And thanks!  Many of us have heard of the myth of Narcissus-- the Greek hunter who saw his reflection in a body of water and was so overcome by his own beauty that he fell in love with the image and could not bear to leave it. He ended up dying, although the means vary from one version to the next. But the basic idea is that Narcissus could not love anyone other than himself. Fast forward to now, 2019, and we can all attest to the longevity of the Narcissistic character. So I thought I would try to shed some light on this problem, because it's actually more complex than you might expect. First, there are different types of Narcissism-- While it’s true that at its’ core narcissism can be thought of as self-involvement it can manifest in so many different ways that I think it’s often missed. The obvious narcissist is what psychologists call the Exihibitionistic or Grandiose Narcissist. This is the person who clearly is “in love” with themselves (or so it appears!). They strut around preening and posing and letting everyone around them know that they think they are superior. They try to surround themselves with other “special” people and are strongly drawn to wealth, power and status. They can be obsessed with their physical appearance, wanting to appear young, sexy and attractive at all times. They can become fixated on small flaws-- a mole, a small fat deposit-- and go to extreme measures to “perfect” themselves. They tend to be immature and may have tantrums. They tend to blame others. Apologizing is not in their wheelhouse. They are competitive and must have the newest, best things. They tend to treat their children as extensions of themselves and want their children to reflect well on them. Their children must be well groomed, well educated, well mannered and they must excel in everything important to the narcissistic parent. They expect everyone around them to adore them and see them as powerful and worthy of worship. They take advantage of others as, clearly, they deserve special favors, status or exceptions to rules. They may exaggerate their accomplishments in order to win approval of others and tend to be envious or assume others are envious of them. Yes, they are exceedingly annoying to be around. What a lot of people don’t know is that narcissists, the exhibitionistic kind and others, actually don’t love themselves. Quite the contrary, they secretly (and usually unconsciously) deplore themselves. If they were to be able to get in touch with what is going on in the deepest levels of their mind they would see that they loathe themselves and feel inferior, ugly, useless and without value. This is why they have such a strong need to appear the opposite and cannot tolerate any criticism or question of their perfect veneer. They usually had childhoods where their emerging authentic self was not accepted. Typically they had narcissistic parents themselves who needed them to fit into a particular mold rather than be themselves. These parents would often withdraw love or affection as punishment if the child was not acting the way the parent wanted, even if that was as simple as the child having a different favorite color or food from the parent. This kind of rejection of who the child fundamentally is gets stuck deep down as a feeling of being emotionally abandoned. This abandonment feeling is mixed with shame, guilt, loneliness and feelings of emptiness at not having the approval of the parent, but also rage at being rejected. That rage can oscillate between being directed at others, who are seen as the potentially rejecting parents, or at the self in an attempt to kill or harm the “bad” self that the parent rejected. However again the self-loathing is deeply unconscious and usually is not expressed directly but rather projected onto others who are then tortured for their failures. Sadly one way or another if you are around a narcissist you are likely to be the object of their scorn, at least eventually. All of this inner conflict is not only shoved under the rug with narcissism, it is usually then covered in six feet of steel-reinforced concrete and then buried under a mountain. People around the narcissist rarely see the inner turmoil and the narcissist is almost never aware of it other than a vague sense that other people need to be kept at bay and cannot be trusted. This is the narcissist's fear of being vulnerable and letting anyone get to know them, lest these inner painful wounds come to the surface. So, if this is the Exhibitionistic Narcissist, what are the other types of narcissism? The flip side, so to speak, of the Exhibitionistic Narcissist is the Closet Narcissist or Fragile Narcissist. These people look on the outside as though they have poor self-esteem. They tend to be self-effacing and anxious and shy away from the spot-light tending to end up in supportive roles (often with an Exhibitionistic Narcissist). They are the “wind beneath the wings” of the more grandiose Exibitionistic style. However, don’t be fooled. These people are still narcissistically organized but are manifesting it differently. Instead of competing in the world directly to be the smartest, best, richest, most powerful, etc. person in the room they want to affiliate with that person. They want to work for them, marry them or be their best friend. They do this so that they can get the feeling of also being important by admiring and supporting the Exibitionistic Narcissist. These people usually had narcissistic parents who would attack them if they tried to “steal the spotlight”. These parents did not want their child to be #1 on the debate team because it made the parents feel inferior. They wanted their children to worship them but at the same time make themselves small so as not to compete with the parent. These kids grow up craving and needing the adoration that the Exhibitionistic Narcissist needs but they go about getting it quite differently. If confronted about possibly being selfish or self-interested they are quick to defend that they “do everything” for the Exhibitionistic Narcissist in their life, not admitting that the reason they are providing all of these “goodies” to the Exhibitionistic Narcisisist is so they can bask in that person’s reflection (which is essentially self-serving). The Closet (or sometimes called Fragile or Covert) Narcissist does not have the inflated defenses of the Exhibitionistic style and therefore is more prone to experiencing envy and low self-esteem that they are painfully aware of. They are also more likely to be depressed and may fail to achieve their potential in life. Finally there is one more type of narcissistic type-- the Malignant Narcissist. You can think of this person as a cross between Narcissistic pathology and Antisocial Personality Disorder. While the Exhibitionistic Narcissist may be difficult to be around (a “blow-hard” , “egomaniac”, insensitive, etc.) the Malignant Narcissist is dangerous. They are cruel, sadistic, deceptive, manipulative and see themselves as “above the law”. They are likely to commit criminal acts (although if highly intelligent they may never be held accountable). They are often rageful, vengeful and dehumanize those they have contempt for. Your Exhibitionistic Narcissistic uncle may forget to tip a bell hop at the hotel because he is so focused on bragging about how he was upgraded to the penthouse because he knows the owner; but the Malignant Narcissist may spit in the direction of the bell hop and use racially derogative terms to let him know he does not deserve a tip. Or if he feels the bell hop has offended him in some way he may stalk him over the weekend, determine which car in the employee lot is his, and slash his tires. These people are criminally-minded and not only lack empathy but enjoy hurting others. Malignant Narcissists are sometimes called Pathological Narcissists and are definitely the kind of narcissist you need to stay away from at all costs. If you have a narcissist in your life, and many of us do, it helps first to figure out if they are the Malignant kind. If they are then you really need to protect yourself with strong boundaries. These are predatory people who you cannot trust in any situation. However if you have an Exhibitionistic or Closet narcissist in your life you may choose to continue to have a relationship with them. However you would do wise to understand that they are never going to be great at empathy, are extremely vulnerable to shame and feeling exposed, and are often not self-aware to any degree. Narcissism is actually one of the earliest pathologies to develop (it comes about from problems between the parent and child before the age of 3) and as such it is very difficult to change. Interestingly twin-studies on narcissism show a 64 percent correlation, indicating a strong genetic component. Medications do seem to be helpful for the condition. There are psychotherapies that help narcissists (usually ones that focus on "transference", or the relationship between the therapist and the client). However narcissists rarely seek out therapy. So those in relationship to them shouldn’t hold their breath and it may also be a waste of time trying to confront them. Adjusting your expectations around a narcissist may be the most reliable way to manage the relationship. And it does help to remember that deep down they are just a little kid who feels they cannot be loved for who they truly are. I hope this information helps make sense of what you may be hearing in the media or over your holiday meals with extended family... And as always if this information has been helpful or interesting to you please reference it on Twitter, Facebook or any other social media you use. It will help others find good mental health information. And thanks! As always wishing you peace and happiness, Dr. Jordan  As a research-oriented person who spent A LOT of years in college I am a bit inclined to think that if something is simple it may not be very effective. I am often fond of saying to a new client "if your problem was easy to fix you would not be in my office!". And while on the whole I do believe that to be true, I have had a humbling experience with one particular "intervention" that is, at least in practice, quite simple. That intervention is monitoring and changing "self-talk". So what do I mean when I say "self-talk"? Have you ever dropped a glass of water and as it shatters on the floor making a huge mess thought "God I am such an idiot!". Or locked yourself out of your house and thought "I can't believe I could be so stupid!". Well, that's self-talk. The interesting thing is that not everyone calls themselves stupid or an idiot when they make a mistake. Yes, I know, hard to believe. As someone who grew up with a lot of negative self-talk I was surprised to realize at some point that 1) I was doing it (we often don't realize what the inner dialogue is) and 2) that changing it would make any difference. But I was in for a big surprise because tracking my inner dialogue and making a conscious effort to change it paid big dividends. Exactly how did I do that? Basically every time that I made a mistake and felt that inner "wince" I tried to pay attention to the default response I gave myself (see above for real examples!). And then I would imagine talking to a 5 year-old who made the same mistake and tried to picture what I would tell him or her. For example if one of my kids at age 5 had dropped a cup of water and it broke and spilled all over the floor I would certainly not have yelled " you idiot!" at them. Of course I might have felt frustrated at having to clean up the mess but I would have said something like "Oh bummer, it broke. Well, accidents happen!". By saying that I would be hoping to avoid the kid feeling too much guilt or even shame. So basically I started talking to myself like a 5 year old ;-)  And it worked. Yes folks, all of those years in graduate school, all of those deep analytical texts I devoured, all of the fancy theories I can wax poetic on... and one of the most powerful tools I have found for helping people love themselves more and be less self-critical is to talk to themselves more lovingly. And it's not just me. While I often like to try interventions on myself before unleashing them on clients (and I highly recommend this to all therapists) I have tried this intervention now with dozens of my clients over the years. The feedback has been overwhelmingly positive. One person I worked with for several years said it was the most powerful thing he had learned from me. And while I hope that I can offer a lot of different useful tools and transformative experiences in the end sometimes just one thing can make a lot of difference. What prompted me to think about this today happened to be something in my in-box from a group dedicated to helping people who grew up in dysfunctional families. It's called Adult Children of Alcoholic AND Dysfunctional Families and it's a 12-step group. The email contained the following text: "Many adult children struggle with self-forgiveness because we are oriented to doubt ourselves or to be hypercritical of ourselves as children." Big Red Book p. 234 We carry messages in our heads that if we do something and anyone has a negative reaction, we must have made a mistake. And if anyone tells us we did something wrong, our first thought is, 'Of course they're right!' It doesn't matter whether we actually did something wrong or not. We tell ourselves things like 'I should have known better!' 'What's the matter with me?' ... These are like the messages we heard as children that became so ingrained that we learned at a very early age to say them to ourselves." And this group has hit the nail on the head. We learn this from our parents growing up. This can happen in different ways. Our parents may have literally told us we were stupid or "should have done better" or "weren't living up to our potential" or that we were lazy. Or any number of criticisms. Some parents simply don't know that criticizing a child is not the best way to motivate them. They were probably criticized themselves as children and are just doing what they learned. Some parents are able to not directly criticize their children but convey disappointment in other ways such as sighing when you bring home a less than perfect report card or favoring your older sibling who is the all-star athlete and not spending as much time with you since you are not the shining star of the family. We can learn in various ways that perfection is the standard and that bad things happen when we are not perfect ( or at least really, really good). I invite you to conduct an experiment. Listen to your self-talk. Especially when you mess something up. If you notice that it is negative, harsh, critical, punitive or unforgiving then I invite you to try changing it to something more positive. I am not saying that when you realize that you forgot to pay that traffic ticket and now there is a warrant that has been issued that you should applaud yourself. I am saying to talk to yourself a bit like this "well, I had a lot on my plate last fall and I can see how that got away from me. I will take care of it now and move on. There is no use beating myself up about it, no one is perfect". Try it. See what you find out. You just may be pleasantly surprised. And while it's no substitute for therapy if you are having big struggles it can be a step in the right direction to feeling less guilt, shame, low self-esteem, anxiety and depression. Wishing you happiness and healing, Dr. Jordan   We've all heard that its hard to teach an old dog new tricks. But what about humans? How easy is it to change a person? We've all tried to make changes to ourselves, whether it's losing weight or stoping smoking...and sometimes we can do it and sometimes we fail. So clearly people can change, but clearly it's not an entirely easy process! Psychotherapy is, at it's core, designed to change people. We do this through helping people have new experiences that are more in line with their goals of who they want to be and how they want to operate in the world. Our brain is shaped largely by experience. If you have the experience of practicing piano every day then the pathways of neurons (brain cells) that are used to play piano get stronger. Think of neurons like muscles-- the more you work them out, the stronger they get. So if you work out the same "set" of neurons (a "neural pathway") every day, say by practicing piano, then those get stronger and stronger and easier to activate. This is how we build proficiency in things, like playing baseball or practicing piano, or even being good at making small talk. Some people grow up in families where they don't have certain experiences like being able to talk about their feelings, or being able to ask for what they need from others. When those experiences are missing in childhood those neurons that are associated with that behavior are weak and hard to activate. Psychotherapy aims to provide experiences that were missing in childhood (or adulthood) that are needed to build adaptive behaviors that help us lead happy and fulfilling lives. So for example a person who grew up in a house where it was not OK to talk about one's feelings gets to talk openly about how they feel in therapy. That in turn exercises those neurons and strengthens that neural pathway so that talking about one's feelings becomes easier and easier. In a very real sense psychotherapy is like hiring a personal trainer at your gym-- a person who can learn about how you would like to be (versus where you are now), set up an "exercise routine" to work out those muscles (neurons) and take you through those steps so that you can develop the muscles (skills) that you want. If we were to take a "before" and "after" picture of your brain we could actually see those neuronal changes that are a result of psychotherapy. As a matter of fact, studies have shown that one impact of psychotherapy is that the connections between the frontal lobe (which involves planning, organizing, regulating emotions, understanding consequences, controlling impulses and lots of other things we associate with being mature and healthy) and the limbic system (which is associated with raw emotions that can be overwhelming and "messy" if not regulated) are strengthened. So in a very real way psychotherapy helps your brain use the "smart part" (frontal lobe) to regulate your more primitive emotional center. This give you more control over intense emotions that otherwise may derail you from staying balanced. The bottom line here is that our brains do change. Even in adulthood. This is good news for those of us who would qualify as "old dogs"! So if there are things about yourself that you wish were different I would encourage you to consider psychotherapy. As one person put it, "it's never too late to have a happy life". Wishing you heath and happiness, Dr. Jordan IF YOU WOULD LIKE TO SET UP A FREE 30-MINUTE CONSULTATION WITH ONE OF OUR THERAPISTS FILL OUT THE FORM BELOW AND SOMEONE WILL GET BACK TO YOU WITHIN 72 HOURS  It should be no surprise with the rapid advances in genetics these days that they have identified a gene that may help to explain what a lot of folks call the Highly Sensitive Person. A researcher at the University of California Berkeley, Dr. Levenson, postulates that a variation of the serotonin transporter gene on chromosome 17 may may account for people who feel their emotions very acutely. This serotonin transport gene can have two common variations-- the "short allele" or the "long allele" version. It's the short allele version that seems to be responsible for some people feeling things more intensely. This gene variation also seems to be correlated to higher rates of depression, anxiety and ADHD. Which bolsters what clinicians who work with those populations have noticed for decades-- that if you have anxiety, depression or ADHD, you are likely to have not just one of those but two or even all 3. And that if you have some of those difficulties you are also likely to see those same problems in blood relatives, hinting that there is a genetic linkage. Dr. Levenson posted a fantastic youtube video that explains his research in a very understandable and fun format (he even uses emojis!). If you resonate with the idea that you tend to feel things more deeply than others you may want to look at other sources of information about this trait such as the wonderful website The Highly Sensitive Person which has books, videos, research links, self-tests and more. So if you are a highly sensitive person what can be done about it? Well, years ago I encountered a theory in psychology that seemed so completely WRONG to my therapist's ear-- that the goal of therapy should not be to change people but teach people who they already are and how to live the in the world given who they are. Anyone who reads my blog or does therapy with me knows that I am a huge fan of splitting the difference, finding the middle path or blending opposing ideas. So while at first I balked at what sounded like a completely hopeless perspective-- that we should not try to help people even try to change-- I came to realize that there is room for some of this perspective in my view of personal growth. Whether you are a Highly Sensitive Person, someone with ADHD (you can be both of course), an extrovert or on the spectrum, all of which are known to be highly genetically determined, or have some other genetically linked trait, you CAN make some changes to how you operate in the world. And, at the same time, there WILL be things you cannot change and, as the old 12-step saying goes, it's learning "the wisdom to tell the difference" that is the key to really thriving. So if the idea of a highly sensitive person resonates with you I encourage you to learn more about it and educate those that are close to you so that your behaviors do not get misinterpreted. Then set about learning how you can navigate the world with a little more comfort. A few examples of HSP that I have known or worked with-- one woman notices that too much noise is very overwhelming for her, so she has skin-colored ear plugs that she wears if she is going out in public (like the mall, a noisy restaurant, etc). They dampen the ambient sound but she can still hear the people she is talking to just fine. If this idea appeals to you I suggest trying the off-the-rack cheap kind first and if you really love them you can order ones that are more high-end or even have them custom made by shops that cater to musicians. Another HSP I know gets a lot of anxiety when entering into social situations because of the increased complexity of interactions. The combination of more voices, conversations bouncing around, more eye contact, etc. just jangles her nerves and she used to find herself making excuses and not joining into groups. Once she learned that she was an HSP she experimented with different methods of entering into groups that reduced her feeling of exposure to the increased input. She found that when she enters a room, house, venue, etc. if she can wait a minute (she can pretend to check her cell phone, go find a restroom, etc.) her nervous system has time to acclimate to the new environment. Once she has done that if she is still feeling a bit overwhelmed she can stand sideways to the group (this does not have to be too noticeable, the main thing is the have your torso perpendicular to the group but your head can be facing them). This has an interesting impact on the mammalian nervous system. Mammals are most physically vulnerable when their guts are literally exposed. So when one mammal faces another mammal if their torso is exposed the mammalian brain notices this and there is a deep evolutionary alarm that can sound and may feel like anxiety. This is especially likely if the group includes people you don't know or if you are in an environment you have never been in before (a new restaurant, a new friends house, etc). But by simply turning your torso 90 degrees, like you would if you were fencing, your mammalian brain is more likely to ratchet down the threat level and you will relax more. For this particular person she even had a third level of "defense" for her nervous system if the first two things did not help enough-- she to develop particular imagery that was settling to her nervous system (if you are not familiar with the amazing power of guided imagery I recommend taking a look into it!). For this person imagining standing behind a huge one-way mirror when she was entering a new group was helpful. In the mental image she could see others but they could not see her. This deactivated her fight-flight response that was predicated on the idea of being seen. Again --to go back to how we are just large bipedal animals dressed in clothing-- being seen is the first step to being eaten. So for some HSP just being looked at can trigger a lot of anxiety. Because the brain, while in some ways is extremely sophisticated, in other ways it is very dumb. Sometimes the brain does not always know the difference between a very well rehearsed imagery and reality (just try thinking about biting into a lemon and see what your salivary glands do). So once this person had locked-in to that image as one that reduced her anxiety and she had rehearsed it numerous times she could call it up when under stress in social situations and it would reduce her feelings of being overwhelmed. Again I am not suggesting that a HSP can turn themselves into a non-HSP. On some level we are who we are. But learning strategies to help modulate one's innate responses can give us more flexibility in our lives and lead to less stress and anxiety. If you feel you are an HSP therapy can be a wonderful way to learn about yourself and get some help managing your beautiful but slightly tricky nervous system. Our office offers FREE 30-minute consultations so you can see if any of our therapists would be a good "fit" for you. And if you are an HSP in a relationship couples therapy can be a wonderful way not only to learn about yourself but to have your partner also learn about you in ways that can deepen the intimacy and de-personalize some of the problematic things that can crop up with a HSP in partnerships. As always I wish you well in all of your endeavors and explorations in life, whether you are an HSP or not. The world has room for all of us and we all contribute in meaningful ways to create the rich diversity of the human condition. Warmly, Dr. Jordan PS If you have found this blog to be helpful PLEASE help us reach more people! "Like" it on Facebook or "tweet" about it on Twitter. Or share it in whatever other social media aps you use! And thanks for helping us get more mental health information out to the public!  First I need to give credit to the originator of this metaphor, a friend and mentor Dr. Stephen Finn. Dr. Finn is a psychologist in practice here in Austin, Texas and is on faculty at UT Austin. He has mentored many psychologists over the years and is a world-renown expert on psychological assessment. If you are interested in psychological assessment you may find his website, www.therapeuticassessment.com, of interest. Now that I have given credit, let me explain what "saucering" is. When an infant is born, he or she has a very limited capacity to tolerate distress. This is why babies cry as much as they do. When they are cold they cry. When they are wet they cry. When they are hungry they cry. This is because they really can't do much to help themselves. Not only can they not change their own diaper or get their own blanket, but they can't tell themselves "well, it's OK that I am cold/wet/hungry right now because I know that it's only going to be a few minutes and then someone will come and take care of me". They can't do this because they don't' have a sense of time yet, a or of cause and effect , or of problem solving, etc. So they are just stuck with their crummy feeling and it doesn't take long before they feel overwhelmed and start to cry. So if you think about their capacity to tolerate upsetting feelings (physical or emotional) as a container, it would be very small. An infant, for example, would have maybe a thimble-sized container inside of them in which to store painful experiences. Once that thimble is overflowing with distress the baby will start to fuss and cry because they are overwhelmed. Feeling overwhelmed is not good for your nervous system. Our brains and bodies were not designed to manage distress for long periods of time. This is what people are talking about when they discuss stress-related illnesses. Long-term emotional or physical stress taxes our bodies and our psyches. So we don't want that little baby to sit in their distress for very long. We know that they only have a tiny little capacity for distress and we need to be ready to swoop in and put a saucer under their thimble. That way the over-flow is caught and doesn't make a big mess. When a parent or caregiver is able to quickly come in and put a saucer under the thimble of the baby when it starts to overflow, the baby learns that "OK, that was really uncomfortable to feel overwhelmed, but someone came along quickly and helped me contain it so it didn't' make a huge mess". And through that experience the baby learns to expand his or her capacity for distress. So over time the thimble-size container grows and becomes larger-- say a small teacup or espresso cup. So now the baby has more capacity to manage distress the next time it comes up. Over the span of one's childhood, if the person is lucky enough to have parents who can provide support quickly and adequately, the capacity to tolerate distress grows considerably large. By adulthood if all goes well a person has a container inside of them that is the size of a rain barrel. This means that as they go through their day they can tolerate a lot of stress and discomfort if need be. Which is a fantastic capacity to have in our stressful modern world! However, as you can imagine, if a child grows up in a family where the parents are not able to quickly and adequately support the baby things can take a different turn. Maybe mom is depressed, or dad works two jobs, or one of the parents is an alcoholic, or mentally ill. Or one of the siblings has a serious medical condition. There are many reasons why parents may not be able to adequately saucer their children. But regardless of the reason for the failure the result is the same. The child grows into an adult who still has that thimble-sized capacity for distress inside of them. And this means that they are constantly feeling overwhelmed and flooded by painful feelings that interfere with their functioning. For some people the effects may be obvious-- not being able to keep a job, not being able to maintain friendships or romantic relationships. For others it may be the underlying reason for developing addictions. Or just never fully reaching one's potential. The manifestation of having a small internal capacity for distress is different for different people but it is damaging to all. So what can be done about this? Since the "failure" is in childhood, what can the person do as an adult to work on this problem? Well, it turns out that therapists are fantastic saucers. Pretty much everything we learn in our training is in the service of saucering people. And when you take an adult with a thimble-sized container for distress and put them with a good therapist, the therapist can swoop in and "saucer" the person when they start to feel flooded. And this gives that person the experience they were missing in childhood. So through therapy and repeated experiences of being "saucered" by the therapist the adult is able to increase his or her capacity for distress, just as the child would have. While these changes take time, they are also permanent and far-reaching. If you feel that you have trouble sitting with painful feelings, whether that's anger or sadness or grief or boredom or anxiety…or any other uncomfortable feelings, you may want to consider finding a good therapist. Remember that the most important thing in starting therapy is to feel comfortable with the therapist, to feel that the two of you have a good "fit". Feel free to interview several different therapists-- we don't mind! Any good therapist will encourage you to shop around and wait until you feel you have found someone that you can feel comfortable with. For more information on finding the right therapist for you, see my page on this website entitled "Frequently Asked Questions". Wishing you health and happiness and good saucering, Dr. Jordan If you have found this information helpful please help others find this website by "liking" it on Facebook or "tweeting" about it on Twitter or sharing on any other social media platform. Thanks!  We've all been there. You're in the middle of a screaming fight (OK, some of you are probably not screamers, so maybe a glowering fight) with the exact person that just 24 hours earlier you were feeling so incredibly in love with. Or you are furious with your 15 year-old for breaking curfew YET AGAIN when just last week you were sharing a touching moment with them where they thanked you for being such a great parent. And now you want to kill that same child. Not literally, but...
Yes, it happens. We can hate the ones we love. So what's going on here? Psychologists call this a "complex feeling". It is literally a feeling that is a combination of other feelings. Just like "dusty rose" is a combination of pink and grey, many of the feelings we have during the day are actually combinations of other feelings. There are several schools of thought in my field that believe that there are only six truly distinct emotions: happy, surprised, afraid, disgusted, angry, and sad. Paul Eckman suggested that there are six basic emotions that are universal throughout human cultures: fear, disgust, anger, surprise, happiness, and sadness.Newer research is actually asserting that there are only four! Regardless of how many "distinct" emotions we have, in my experience the ones that really confuse us and cause most of our trouble are the "complex" or "blended" feelings. I feel great about liking my co-worker but then one day when she breaks my favorite coffee mug after I have asked her not to use it. I now have the weird experience of liking her overall, but at that moment being perturbed with her. What's even worse is what if she broke the coffee mug in the process of grabbing me the last piece of that amazing chocolate cake from the kitchen because she knew I was under deadline and missed the birthday celebration? And she knows how much I love cake! Ugh!! Now I feel really confused. Let's add in maybe that I envy my co-worker's amazingly fit figure and she never seems to even want cake. But she brings me cake. I do love cake. And I want cake. But I feel slightly guilty eating it in her presence because her size 6 jeans make me feel insecure. So we now have "happy" (yay! she brought me cake!), "surprised" ("wow, thanks for the cake, I though it was all gone!"), angry ("you broke my mug! I asked you not to use it!") and sad ("that was my favorite mug!"). I also apparently feel envy, which those smarty-pants researchers did not include on their list, but I would assert seems to be a very real feeling for many of us! Why make the fuss about complex feelings? So what. We feel lots of feelings at the same time. Well, in my experience, lots of people find complex feelings unsettling. In fact, being able to tolerate complex feelings is a real developmental achievement according to mental health practitioners. Humans like to keep things simple. It frees up processing space in our brains. Really. We like to sort things into categories-- good/bad, smart/dumb, safe/dangerous, Republican/Democrat... This unfortunate evolutionary tactic to reduce load on our brains so that we can function more efficiently can make it hard to acknowledge or manage complex feelings. It's like being in a tug of war with your cortex-- one part of you knows that this person is important to you and that you like or even love them, but the other part of you is trying to "keep it simple stupid" and focus only on one feeling in that moment. I have learned as a therapist that even just pointing this out is helpful to folks. Again the way humans evolved we are not geared to even notice this much less know what to do with it. So this is one of those situations in which even noticing the problem really helps. The next thing that has proven useful to me as a therapist is literally to tell the person to "make space for" each of the feelings. Don't judge them or try to get rid of one of them. Just notice them (mindfulness skills here!) and accept that they are co-existing in your brain right now. Allow both of them to be there. Don't beat yourself up for having some or all of them. Don't expect yourself to be internally consistent. Humans are inherently internally inconsistent, trust me. The last step in dealing with complex feelings is assessing whether or not the person you are feeling them towards is a safe person to talk to about all of this. If that person generally can take feedback well and does not blow up then I recommend just telling them "hey, right now I feel mad at you but I also love you" or "right now I don't want to be around you but that's weird because I also have missed seeing you". (sidebar-- if the person does not seem like they are safe to talk to and it's someone that is important to you-- a spouse, a child, a friend-- you probably want to consider doing some therapy with that person to improve the communication between you!) Mixed feelings are only problematic if you try to ignore them or judge yourself for having them. If you just let them sit there like the weird little creature that they are (OK, maybe weird BIG creatures if you are a big feeler like me!) and be like "oh, hey, yeah I see you there. It's weird that my love for my spouse is sitting right next to my desire to throttle him right now. Yep. Weird. But OK." then they will tend to subside. If you can accept the incongruence and explore it and hopefully talk about it the discord usually resolves all on it's own. Until it comes back. Which it will. Then it's wash, rinse, repeat. Welcome to humanity. If you struggle with accepting feelings in general, or maybe just some specific feelings like hate or envy or whatnot, take a look at my blog on Acceptance and the resources there. And as mentioned above, Mindfulness also has great skills to help with tolerating things that make you uncomfortable. The more you can tolerate and accept what's going on inside you the more energy you will have to fight battles on the outside of you, like getting your taxes done or cleaning out the garage. Or maybe planning that fabulous vacation. Wishing you health and happiness even when you feel conflicted, Dr. Jordan  Attachment styles represent the strategy that we learned as infants in order to keep our caregivers in close physical proximity. Human infants literally can't last more than an hour or so without having an adult caregiver nearby. Babies MUST keep this in their awareness and work hard to keep their caregiver close. Different caregivers respond to different methods in order to maintain contact. If you have a parent who is highly distractible, for example, it would pay off to intermittently cry or fuss a bit so that s/he doesn't forget that you are there. And you probably also want to cock your head in their direction periodically to see if they have absentmindedly wandered off on you. Now if you have a parent who doesn't like to be bothered you might try the opposite strategy-- be quite and don't cause a fuss. That way your parent will let you lie close by and stay safe. Infants are hard-wired to develop these kinds of strategies to adapt to whatever caregiver they end up with. Kids who learn to "signal" a lot and keep track of their caregivers are termed "Anxious-Ambivalent" or "Angry-Resistant" in infant research. Dr. Stan Tatkin calls them "waves" as adults. Kids who learn to lay low and not ask for much are labelled "Anxious-Avoidant" or just "Avoidant". Dr. Stan Tatkin calls these folks "islands" as adults. Kids who are lucky enough to land a caregiver who does not need much adapting to are called "Secures". There is a third attachment quality that was not even realized in the early research. These are kids who are in a bad dilemma. The caregiver they are with may, at times, provide nurturing and support. But that same caregiver can also be neglectful, abusive or can accidentally do things that scare the child. Researchers found that parents did not even necessarily need to be abusive or neglectful to produce this attachment pattern. Parents who had themselves been abused or neglected sometimes looked scared when their babies cried. It's as if they were remembering on some deep level their own experiences of distress and fear related to their own parents. Babies see these faces full of fear and become fearful themselves. This stems from our evolution as primates who survived by living in groups. If one monkey in a tree sees a tiger it looks scared. A monkey sitting next to this one may not see the tiger but sees the fear on the face of its friend and therefore also gets scared. This fear behavior triggers a fight/flight response in BOTH monkeys. The one who saw the tiger and the one who only saw his friend looking scared. But now both monkey's bodies are in a fight/flight state, giving them both an equal chance of getting away safely. So as humans when we see someone who looks scared, we also get scared, even if we have no idea what they are responding to. To a dependent baby, having a caregiver who is all of a sudden acting scared or checked-out can generate fear in the infant. Babies depend on caregivers to be calm and present. So if they see you really scared or off in another place in your head for more than a few second they can get scared themselves. Are you going to be able to take care of them in that moment? Will they be safe? This kind of situation, if it happens regularly, can create what we call and "unresolved" or "disorganized" attachment style. Babies can, of course, also end up with a disorganized style from direct abuse or neglect. So if your parent was violent, or regularly threatening, or even severely depressed or drunk a lot of the time, you may as a baby have been scared that you were not going to be well cared for. And you may have had experienced where your caregiver was directly hurting you. This puts you in a bind-- the same person who is supposed to help you feel safe is now making you feel unsafe. The human brain does not have a good way of dealing with that dilemma. The kids are trying to attach to a parent to stay safe (our evolutionary strategy of being physically close to our protector) while at the same time either knowing in that moment that the parent may not be safe or having had numerous experiences that the parent has not been safe in the past. As Dan Siegel, MD, explains it "The child is stuck in an awful dilemma: her survival instincts tell her to flee to safety, but safety may be in the very person who is frightening her. The attachment figure is thus the source of the child’s distress. Children in this conflicted state develop disorganized attachments with their parental figures. Disorganized attachment arises from fright without solutions." Children who simultaneously feel a desire to move towards their parent for comfort but remember also not feeling safe with the same parent are caught in a "double-bind". There literally is no solution for this situation. Researchers observed a lack of organized behaviors in these babies because they could no reliably predict the right way to respond to their parents. They were called "disorganized" babies. They would display a mix of behaviors. For example, when upset they may start to crawl towards a parent, only to freeze mid-way and "zone out" for 10+ seconds. This is what is considered a "lapse" in strategy. A secure baby will continue to move towards the parent, not stop mid way and freeze for a prolonged period of time. Or a baby may back away from a parent when upset, which is the opposite of what a secure baby will do. Of all of the 4 strategies researched these kids had the highest risk for bad outcomes such as mental illness (including depression, anxiety, substance abuse, personality disorders, etc). They were also at risk for criminal behavior and had more trouble in school academically and behaviorally. Kids in this category show more dissociation-- from mini episodes to more prolonged states of "checking out". They may also block experiences from memory so that they have gaps in memories from childhood. For example they may say when interviewed "I don't remember second grade. It's just a big blank". If you are a parent you may be freaking out right now thinking "oh no, did I ruin my children? Was I a terrible parent?" Let's be clear. No parent is perfect. I know because I am a parent and I have worked with hundreds and hundreds of parents in my career. Even great, wonderful people make mistakes rearing children. Some of us make BIG mistakes. Almost never because we don't care and even more rarely because we are trying to make our kids miserable or mess them up. I am fond of saying that the incidence of psychopathy is less than 1% of the population. Psychopaths are the only type of people who would lie awake at night trying to figure out how to ruin their child's life. So 99% of parents, no matter how poorly they are doing, are actually trying to be decent parents. But unfortunately sometimes even a parent who is trying to do a good job can lack the tools and create these fear states in their babies too often. How often does this happen? Research suggests that anywhere from 15-30% of average (not particularly high-risk) families babies or toddlers meet criteria for disorganization. If you limit it to just "high risk" families (where at least one parent has a serious mental illness, substance abuse problem or is violent) then the risk for disorganized/unresolved attachment jumps to 80%. So if you are a therapist you should expect to see more disorganization than not in your practice. If your childhood background includes abuse or neglect it is probable that you also meet criteria for this type of problem. Or if one or both of your parents experienced abuse or neglect in childhood or suffered from unresolved PTSD as an adult. How does this show up in your everyday life? Remember that our attachment system most strongly triggered in two situations-- parent-child interactions and long-term romantic partner interactions. So with friends, or co-workers, or the person who is checking you out at the grocery store you are not going to see much fall-out from this. But as mentioned above, if you are a parent and your child does something that reminds you of your own fears in childhood, you may either look or act scared, move into anger or dissociate. In romantic relationships you will likely have trouble soothing yourself when you get upset (similar to those with the anxious-ambivalent/angry-resistant style). But you will ALSO, simultaneously, have trouble using another person to soothe yourself (similar to the anxious-avoidant/avoidant style). Again, like the disorganized baby, you are caught in a dilemma with no clear solution. You will want comfort from your partner but feel anxious/fearful about how to effectively engage them. It is likely that you will have difficulty trusting your partner. This can actually trigger your partner to feel as though you can't be trusted! You are may frustrate your partner as your signals are confusing. Remember, you are not doing this on purpose! You are stuck in a dilemma from your early childhood which you had no control over. So what can be done about this situation? First, if you think you may have a disorganized/unresolved style I STRONGLY recommend seeing a therapist who is both trained in attachment theory AND trauma treatments. This will give you the best chance of moving from what in adults we call an "unresolved" style to a "resolved" one. Making this jump helps to reduce or alleviate the problematic behaviors of not being able to trust or rely on your attachment figure and problems in self-soothing. This type of work can be done in individual therapy or in couples therapy as long a the therapist has the right training. It is not short-term therapy, you can expect it to take a year or more rather than weeks or months. However it is definitely worth the investment! Dan Siegel, MD, has developed an online course that helps with creating what is called a "coherent narrative" to work on an “Unresolved Style ”. I also strongly recommend actually working in person with a therapist as this is how the human attachment system was meant to be "wired"-- through live interaction with another human nervous system. This is definitely not the kind of problem that you can fix by reading articles about it and journaling or doing phone therapy or even Skype or FaceTime therapy. You need to be in the room with a real live therapist. I hope that understanding this category of attachment is helpful. Remember, as much as a third of us from "low-risk" families may be disorganized and the rates are even higher if your parents struggled with significant emotional issues including their own past childhood trauma. No one is passing this along on purpose". And having a disorganized/unresolved classification does not mean that you cannot be successful in life. I can hazard a guess that certain well-known figures who have become very successful probably would fit into this category (think any celebrity/public figure who have mentioned abuse or severe neglect in their childhood, such as Oprah Winfrey, Maya Angelou, Chevy Chase, Queen Latifah, Bill Clinton, Gloria Steinham, Ludwig van Beethoven, Billie Holiday, Carlos Santana, Johannes Brahms). If many of these highly successful people can rise above their difficult childhoods and potential unresolved attachment then we all have that capacity. However, getting the right kind of help will significantly increase your odds and make the journey a lot easier. And just to make sure that my blogs are completely scientifically accurate I need to add an addendum here. Researchers never simply classify a kid (or adult) as disorganized/unresolved. They always give a secondary classification of "best fit". So you can be avoidant and disorganize/unresolved, or angry-resistant and disorganized/unresolved, or even secure and disorganized/unresolved. The disorganization/unresolved category has to do with whether or not your attachment strategy is consistent or if it gets derailed and confused when under stress. The other classification of best-fit has to do with what most of your attachment behaviors look like aside from those episodes of disorganization. Hopefully this explanation itself is not too confusing! Attachment research is rich and complex and sometimes difficult to explain. However, understanding some of the basics about it can be IMMENSELY helpful to individuals and couples. One final note. If you find "attachment style" quizzes on the "inter webs" (as my friend Margaret likes to call it) please know that, so far, research has not found self-reports like quizzes that you fill out about yourself to be terribly accurate in determining your attachment style. I can attest that when I first learned about attachment I thought I was definitely and completely a wave but actual attachment testing later proved me wrong! So be careful about assuming you know for sure what your own classification is. We seem to have a hard time assessing this component of ourselves without an outside observer. If you are interested in having your attachment style professionally determined you can look for a clinician who is able to administer the Adult Attachment Inventory or the Adult Attachment Projective. Those are two well-researched, well-validated instruments that can tell you what research category your attachment behaviors fall into. A PACT-trained couples therapist can walk you and your partner through various exercises that can also tease out what attachment style behaviors you manifest with your partner under attachment-related stress. As always I hope that this information is helpful and if you have questions or comments feel free to send them to me! Wishing you success in your relationships, Dr. Jordan PS If you have found this post to be helpful PLEASE help others find it by "liking" it on Facebook, tweeting or using any other form of social media to share it with others! And if you like learning about human behavior, health and relationships you can subscribe to my blog and have them send directly to your email inbox! I do not share your email address with anyone and you can unsubscribe at any time. |
Krista Jordan, Ph.D.Dr. Jordan has been in private practice for 20 years in Texas. She is passionate about helping people to overcome hurts and obstacles from their past to find more happiness and health in their current lives. Archives
May 2020
Categories
All
|
RSS Feed
