Karuna Counseling’s Newsletter Articles

July 17, 2012

The Thinking Mind

by Molly Keeton Parnell, Ph.D.

“Mind, body, and breath complete the circle of life”

This is what my yoga instructor stated last week as we were moving into Savasana, or the meditation portion of the class. This observation gave me pause for a moment and then quickly resonated as true. I was immediately aware of how much more time my mind spends actively thinking compared to the miniscule amount of time that I spend just “being” in my body and with my breath. For a moment, I was absolutely captivated by the fact that while we are equally mind, body and breath, the mind takes about 99.9% of the airtime. I suddenly had the image of a horse drawn carriage with the coach using a whip to keep the horse going. The mind is like that coach, whipping the attention back to itself over and over and over again. If the mind even begins to wander towards a moment of quiet, there’s that crack of the whip and we are again deeply entrenched in thought. On the contrary, for most of us the body only demands attention in the case of physical discomfort (and even then, the mind never stops going full speed. It may just share some of the real estate with awareness of body). And it seems that the breath almost never dominates our attention, unless there is some respiratory illness or perhaps a panic attack, where the ability to breathe is perceived to be diminished. In fact, a panic attack is a good example of the connection between mind, body, and breath because of how quickly the mind jumps in to perpetuate the sense of panic. Shortness of breath may be a cause of concern, but it only turns into a full blown anxiety attack when the mind starts putting negative labels on the feelings in the body, which causes an intensifying of bodily sensations that lead to more panicked feelings in the mind, and so forth. Just thoughts of not having enough breath leads to what feels like a physical reality of not having enough breath.

And yes, I had all of these thoughts while I was SUPPOSED to be headed into a meditative state. The irony was not lost on me. I redirected my focus to my breath, yet my mind continued to think about the way it was thinking, about the way that humans seem to be programmed, about my grocery list and messy house, and how well this thinking vs. being struggle would fit into the article that I needed to write. Sensing that my restless and hyper brain was not easily inclined to getting quiet, I opted to give way to trying to force it to happen and instead to simply notice the way that my mind seems to work. I was immediately aware of the desire to let go of thinking and the sense of panic that my mind felt at that notion – the fear of letting go. I then felt frustration that this seems to be such a difficult task, wondering if it is only difficult for me and why I haven’t mastered it at this point in my life and emotional growth. As I started to berate myself for this, I noticed what my mind had done. By beating myself up for my lack of meditation skill I was remaining active in my mind. My mind had tricked me into staying mentally focused by distracting me with the oldest trick in the book – self-criticism. While I did not have the breath-body experience that I wished for, I learned something significant about the various ways the mind manages to stay primary and also found inspiration for this article!

So, what is it that compels us to think, think, think? To think about thinking? To think about how to not think (now, there’s a no-win puzzle for you!)? What is responsible for the non-stop dialogue of the brain, the million thoughts a minute diatribe wherein I can go rapid-fire from thoughts of my to do list, to pondering my spirituality, to worrying about getting my article written quickly, to beating myself up for my habit of procrastinating, to wondering what purpose procrastination serves for me and if I’ll ever find a better way, to reflecting that perhaps I could practice self-acceptance related to procrastination and simply accept it as a part of life?

It turns out that the source of the 24-7-365, not-a-millisecond-off running monologue is the left hemisphere of the brain. You may have heard that left brain dominant people are better at math and right brain people are the artists of the world. And perhaps it is true that people are generally more dominant in one side than the other, but the reality is we all have two hemispheres that work together as a whole yet have dramatically different purposes and functions. In cases where the two halves of the brain have been surgically separated (by cutting the corpus callosum, or the structure that connects the two sides) the right and left hemispheres have been found to operate as two separate brains, each with distinct personalities. In humans with a normally functioning corpus callosum, the two hemispheres of the brain are “more appropriately viewed as two complementary halves of a whole” and “virtually every cognitive behavior we exhibit involves activity in both hemispheres – they simply do it differently” (Bolte Taylor, p. 29). However, scientists still do not fully understand the way the two halves work together. While it was long believed that the corpus callosum created communication between the two hemispheres, recent research supports the idea that the corpus callosum may actually be serving to keep the two halves divided.

The Left Hemisphere

My experience in yoga class can be well understood by knowing the dominance of the left hemisphere and its instinct to remain in the driver’s seat of the mind. The job of the left brain is to sort, organize, and analyze all incoming information. When stimuli is received through our senses (eyes, ears, etc.), the left brain categorizes and notes distinctions, or where things are different. For example, it is your left brain that is interested in better understanding the differences between your two hemispheres.  (Your right brain is in the moment, feeling peaceful, and doesn’t really care what part does what)!

The left brain is “linear and methodical” (Bolte Taylor, p. 31) and sees the details rather than the whole. The left brain manages our interactions with the world by time streaming every piece of data. It both sorts things according to the proper sequence (i.e. we put on our socks before our shoes) and organizes events in their proper place in time (i.e. past, present, and future).

The mechanism by which the left brain completes its duty of sorting, organizing and analyzing is through language. The left brain contains our language centers, which utilize words to define and categorize, or break the big picture down into data bits that are distinct and manageable. For example, Bolte Taylor points out that when out in nature, our left brain sees and labels the distinct parts of all that we see, such as stem, petal, and leaf. The left hemisphere then organizes those details back into the whole to see a flower. It “… thrives on weaving facts and details into a story” (Bolte Taylor, p. 31). It uses deductive reasoning and creates an understanding of the world in this way (i.e. if A is greater than B and B is greater than C, then A must be greater than C).

The left mind’s language centers help us to understand that letters form words and that words form sentences. It is the left hemisphere that comprehends the meanings of these words and sentences, but it can only do so in a literal way. If I say that my friend is really cool, the left brain might want to give her a blanket, whereas the right brain understands the more subtle interpretation of this phrase. We need our right hemisphere to help translate things like humor or sarcasm as well as for interpreting non-verbal communication.

Our left brains also think in ways that become patterned based on incoming sensory information. Neurological circuits are developed and then run mostly automatically. These circuits allow us to take in information efficiently without having to break what we are sensing down into the individual pieces and then reconstruct those pieces into a whole. So, when I see an object that can be easily held in the hand that contains buttons with numbers, I know it is a telephone even though there is wide variation in the way different phones look. Each time one of these neurological circuits is stimulated, it becomes more engrained and then takes less outside stimulation to run in the future. Our left hemisphere then becomes quite adept at prediction, not only predicting how objects may function (a phone will ring) but also how we will feel, react, or respond to things based on the past. Thus, our left brain may give us a story such as “I always turn in my assignments late”, which then gets replayed and strengthened every time the topic of an assignment floats through the mind.

In receiving all sensory stimuli as distinct parts, the left hemisphere also focuses on the separation between ourselves and others. This half of the brain contains the “ego center”, which defines the self as “I” and defines what we do, think, and feel as “I am”. Our constant brain chatter helps us to rehearse and memorize the details of our lives, such as our names, occupations, relationship status, values, preferences, etc. As it is the job of the left hemisphere to categorize, all data is sorted into dichotomous classes such as “good”, “bad”, “like”, or “dislike”. The left hemisphere similarly engages in constant comparison between ourselves and others, using a comparable hierarchy for “better”, “worse”, “success”, “failure”, etc. While the right brain sees connection and wholeness and holds the intuitive knowledge that we are perfect just the way we are, the “… ego mind revels in our individuality, honors our uniqueness, and strives for independence” (Bolte Taylor, p. 33). Guess who wins when it comes to our self-concept? You got it – the left hemisphere.

The Inner Critic and Judge

Byron Brown states:

This is the courtroom of life. And you are the one who is on trial… The judge is a part of your mind… it also lives through your body and your energy. The judge is a master of words, and yet you can feel it in your belly, your shoulders, and your jaw without any awareness of words. The judge is both pervasive and invisible. It speaks to you from commercials on TV, magazine ads and movies, as well as from the expression on your partner’s face, the dirty dishes in the sink, and the tone in your supervisor’s voice (Brown, p. 14).

The inner critic is the part of the mind that continuously and constantly evaluates, compares, judges, criticizes, blames and attacks us and others. The inner critic is always on call to condemn any of our innermost thoughts, beliefs, feelings or desires or which it disapproves. Nothing gets by the critic. It is rigid and perfectionistic, so most of our feelings, beliefs, and thoughts do not escape its judgment. The inner critic is always present but also invisible. It presents its point of view as fact rather than opinion.

The inner critic uses every piece of information ever taken in (from your caretakers, cultural group, school system, church, etc.) about how one is supposed to operate in the world. It is guided by the harsh and punishing attitudes of the environment in which we live. It compares you to yourself – your past self, your future self, the self you should be. It compares you to others, others to you, and others to others.

The inner critic excels in the ego center of the left hemisphere of the brain. The ego exists based on the concept of “I”. When we use the word “I”, we are generally referring to where we live, what we do for a living, what our relationship status is, what our hobbies include, etc. So, I might say I am a psychologist. I am a sister. I am American. I love movies. I might say that I am introverted, I am compassionate, I am a procrastinator. These things are part of my life circumstance, value system, and personality, but are they me? Are we able to say who we are without going down the list of where we came from, what we do, and what we believe ourselves to be?

According to Brown there is a way to quiet the inner critic. To begin the process of “disengaging from self-judgment…” you must begin “knowing yourself as a living soul” (Brown, p. XVII). Perhaps the best way to do this is to learn more about the right side of the brain.

 

The Right Hemisphere

While our left brains maintain dominance throughout most of our lives, it may actually be our right hemispheres that are primary. We come into this world right hemisphere dominant and remain that way until we are about two years old. Furthermore, for all humans at all stages of life, sensory information goes first to the limbic system (the emotional center of the brain), next to the right hemisphere and lastly to the left hemisphere. Information from the heart and the gut (both of which contain neurotransmitters) also goes to the right hemisphere of the brain before the left. This flow of data seems to prove that “… although many of us may think of ourselves as thinking creatures that feel, biologically we are feeling creatures that think” (Bolte Taylor, p. 19).

The right hemisphere functions like a parallel processor that takes in multiple sources of information simultaneously, comprehending at once the “big picture”. The right side contains our emotional sense of self and is responsible for relationships and emotional attachments. The right hemisphere sees the implicit meanings in things and is the part that responds to poetry, metaphor, and humor. It interprets non-verbal communication, such as tone and facial expression. The right hemisphere does not speak in words but rather in images, symbols, pictures and metaphors. If you have ever had an “A ha” moment where a light bulb of understanding suddenly illuminates, that occurs in the right hemisphere.

Our right hemispheres see the connections between things rather than the boundaries that separate. It sees how parts make up a whole. We have our right hemisphere to thank for the gift of empathy, or the ability to place ourselves in the position of another and imagine what their experience might be.

It is our right mind that gives us the ability to remember with crystal clarity certain isolated moments that have significance in our emotional lives (i.e. the first time you exchanged the words “I love you” with your partner or where you were when you heard about the September 11th attacks). The right mind takes in information in relation to other pieces of information and “… Borders between specific entities are softened, and complex mental collages can be recalled in their entirety as combinations of images, kinesthetics, and physiology” (Bolte Taylor, p. 30).

After Jill Bolte Taylor, a neuro-anatomist who had devoted her professional life to studying the brain, suffered a stroke resulting in the total (but temporary) shut down of the left hemisphere of her brain she realized that

…deep internal peace is accessible to anyone at any time. I believe the experience of Nirvana exists in the consciousness of our right hemisphere, and that at any moment, we can choose to hook into that part of the brain (p. 111).

Bolte Taylor learned that in her pre-stroke life, her personality had been dominated by the left side of the brain and by the tendency to judge and analyze. The experience of the stroke taught her that the two sides of the brain not only function in different ways with different types of perception and thought but also contain different types of interpretations for what is perceived. In short, Taylor’s experience revealed that the two hemispheres have quite different value systems and personalities. She found that the right hemisphere is “…completely committed to the expression of peace, love, joy, and compassion in the world” (Bolte Taylor, p. 133) and that “…peace is only a thought away, and all we have to do to access it is silence the voice of our dominating left mind” (Bolte Taylor, p. 111).

However, “left brain is dominant, speedy, and prone to rush in with words and symbols and prefers not to relinquish tasks to its mute partner unless it really dislikes the job or is unable to do it” (Edwards, Courtesy of Courtney Armstrong). How to silence the left mind is a question that Bolte Taylor does not answer. Is it possible to completely silence the inner critic and live completely in each moment?  Is this the goal or should we simply strive for a better balance between the two halves? These are not questions that I can answer for you, but I can invite you to take better notice of the inner critic and when its voice begins to take over.

Without awareness of the way our brains are structured, the judging part remains invisible, which makes it very, very powerful. It brings to mind one of my favorite movie quotes from the movie The Usual Suspects. It goes something like this…. “What is the smartest move the Devil ever made? To make man think he didn’t exist”. I am not trying to make a religious point here but simply articulate that a force is far more powerful when we don’t even fully understand that it is present. Various forms of oppression have been weakened greatly and social systems changed just through consciousness raising, or helping those being oppressed to understand the larger system of power. When something is unseen, how can it be challenged and overcome? Just simply recognizing that the inner critic is a part of the brain rather than some omnipotent messenger of truth does a great deal to lessen its hold.

Brown points out that while we are in the habit of defining ourselves as the “I” – the one who was born in Atlanta, is bad about procrastinating, works as a psychologist and can’t figure out how to keep a clean house – who we really are is a soul. Our right brain seems to be more in contact with that soul and to recognize that as a soul we cannot be compared to any other soul and deemed better or worse. On a soul level we have worth and value that must be separated from the specific details of our lives. We must fully take in that the “uniqueness of the soul is inherent in who you are at birth; it is not achieved, not can it be destroyed, and it is not dependent on your appearance or anything you do” (Brown, p. 31).

To learn more about what life could be like with soul awareness, I invite you to watch Jill Bolte Taylor describe her experiences of living in her brain’s right hemisphere.

http://www.ted.com/talks/lang/en/jill_bolte_taylor_s_powerful_stroke_of_insight.html

References:

Some of the information in this article came from a presentation by Courtney Armstrong, LPC of Chattanooga, TN. Thank you, Courtney, for helping me to better understand this exciting topic.

Other sources include:

Bolte Taylor, Jill (2009). My Stroke of Insight. New York: Plume/Penguin.

Brown, Byron (1999).  Soul Without Shame: A Guide to Liberating Yourself from the Judge Within. Boston: Shambala.

Edwards, Betty (1999). Drawing on the Right Side of the Brain. New York: Penguin Books.

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April 29, 2011

Book Review: “Taking Antidepressants: Your Comprehensive Guide to Starting, Staying On, and Safely Quitting” by Michael D. Banov, MD

Filed under: 2011 Articles,Depression,Molly's Articles — karunacounseling @ 7:13 pm
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A Book Review by Molly Keeton Parnell, Ph.D.

I am pleased to have found a book that I can recommend to clients, family, and friends who are dealing with depression and wanting to better understand their treatment options. While the title of the book indicates the subject matter is that of antidepressants, Dr. Banov does a thorough job of discussing various alternatives to traditional medication therapy, including psychotherapy, supplements, exercise, healthy eating, light exposure, yoga, meditation, and more. The fact that the discussion is not limited only to antidepressant medication makes this book much more worthwhile, in my opinion.

Over the years of providing therapy, I have talked with many clients about antidepressant medication. I have found that it is very, very rare that clients feel immediately open to this option. Many come around and try antidepressants and many do not. I am always amazed by what strong opinions exist about medication therapy. People feel that it is “not natural” (neither is cataracts surgery, but most don’t object to this), that they “shouldn’t need it,” or that they should somehow be able to overcome a chemical imbalance through sheer will. It is not the fact that a person has a negative reaction that bothers me – perhaps we should all be more cautious about our medical care. It is this strange phenomenon that average people suddenly seem to fancy themselves a medical expert when it comes to mental health medications. For example, when I was pregnant, I had to be on blood thinner medication. This involved giving myself injections once or twice a day for the entirety of my pregnancies. I certainly received many reactions from people who knew about this (mostly sympathy and some shock at the thought of taking shots everyday), but I never once had someone tell me that I probably didn’t need the medication, that my doctors didn’t know what they were talking about, that blood clotting disorders don’t really exist, or that I could fix my clotting issue by adjusting my attitude. People almost never question treatment or medication for heart disease, Alzheimer’s, or high blood pressure, but when it comes to mental health issues everyone is suddenly an expert. And most likely they haven’t read the first word about depression or its various treatments.

Mental health disorders and their treatment still carry an enormous stigma in our society, despite the fact that an “estimated one quarter of the population will suffer from depression at some point in their lives” (p. 10) and antidepressants are “the most commonly prescribed class of medications” (p. 7). Because of this stigma, depression is more often hidden and dealt with privately. The downside of this is that many, many people do not comprehend the realness of depression, how it differs from the regular sadness and stress we all face in life, and the serious consequences that can result.

When I think about depression, a funny story comes to mind about my sister. She was living in Oregon with some mountain biking enthusiasts who invited her to join an on-road trek one day. Although she had not done much biking, she was a lover of exercise who was in great health and very good physical condition. She figured she was up for the challenge. From almost the very beginning she had great trouble keeping up. She felt discouraged with herself, first frustrated by her poor performance and then questioning if she had been crazy to think she could do this. She felt embarrassed for others to see her struggling and felt badly for slowing them down. She began doubting everything she knew to be true of her fitness, wondering if maybe she wasn’t in great shape, if her daily runs were not really all that impressive, if she wasn’t a real athlete at all. Finally, one friend who knew she could do better took a quick look at her bike. Guess what they found? Her tires were not properly inflated. She was literally doing twice the work to get half as far. Imagine her relief to discover this – not only was she not the utter failure she was beginning to feel like, but also the rest of the day was sure to go much better. As she set out again, looking forward to the ride ahead, she found that she was still struggling to keep up. The same feelings of embarrassment, self-doubt and inadequacy followed. After more time and more struggle and more slowing down of the other bikers, someone took a second look at her bike. This time they discovered that her brakes were functioning improperly and were actually partially applied. For every push of her pedals, the brakes were working against her by trying to stop her in her tracks. Once this problem was resolved, the day went much more as she had envisioned. She was not at the head of the pack, but she was certainly capable of an afternoon ride with some friends.

I promise that this story is true, and although I am sorry that my sister had to suffer through it, I am so grateful to have this excellent analogy of how depression can feel. It is not necessarily that a person with depression can’t function, that they lay on the sofa all day crying or feeling like dying, that they don’t leave the house, feed the cat, go to work, etc. Though depression can look this way at its extremes, many people with depression can continue to function in their lives to the point that others may not even know they are suffering. It is just that the effort it takes to get through normal daily tasks can feel overwhelming. For many, depression comes on quite gradually so that they might not fully notice its presence in their lives. Like my sister on her mountain bike, they may simply think they are lazy, unmotivated, and incapable of achieving their goals. They may chastise themselves for not being able to get their lives together, get things done, or function as well as other people seem to. Not recognizing that depression plays a part can have devastating consequences. Their goals, dreams, relationships, productivity may be slipping away while all the while self-loathing and hopelessness is growing. Depression leads to a great deal of suffering, and not recognizing and getting help for depression leads to worsened depression and therefore greater suffering. It affects not only the person who has it, but their loved ones as well.

Dr. Banov points out that the “emotion of depression” must be distinguished from “the illness of depression” (p. 38). While we all have feelings of sadness or despair at times, the illness of depression (sometimes referred to as a chemical or clinical depression) is a medical condition that causes changes in the physical body and brain. Brain scans of people with depression have shown decreased activity and even atrophy in the hippocampus (plays a role in mood and memory), prefrontal cortex (responsible for planning and attention), the amygdala (generates emotional response during emotionally charged events), and the thalamus (serves as the “communication hub” between our thinking and feeling areas in the brain) (p. 76-77). Depression also can cause or exacerbate other health problems, by affecting insulin levels and blood sugar, compromising the immune system, and leading to elevated blood pressure as well as reduced muscle tissue and bone thickness (p. 79).

Dr. Banov’s book is so packed full of information, any attempt to summarize would be futile. He covers the types of depression, the brain mechanisms that are involved, the various medications used to treat depression, how these medications are believed to work, research studies that both support and do not support their use, typical side effects and how to manage them, generics versus brand names, what to do if your anti-depressant begins to lose effectiveness or causes a numbing of your emotion (not its intended effect), if antidepressants are addictive (they are not), the when and how of discontinuing an antidepressant, and how to deal with special circumstances such as drug interactions, travel, surgery, or pregnancy. Dr. Banov also covers in depth the importance of having a check up for your physical health and the many physical disorders with symptoms that can mimic depression (i.e. thyroid disorders or diabetes).

If you suspect that you or someone you care about is dealing with depression, I highly recommend this book. It contains so much useful information, it could actually be overwhelming for a person with depression to try to decipher all at once. My personal recommendation would be to read the first few chapters to determine if you might be experiencing depression and what your treatment options are. If you do decide to take antidepressant medication, I would suggest that you wait until that time to read more about side effects or long term use. Having read the book myself in just a few days, I can honestly say it is a lot to absorb. Some topics are covered in incredible detail, such as the functioning of neurotransmitters in the brain, and other topics could have used slightly more attention, such as the types of psychotherapy and how alcohol and illicit drug use can worsen depression. To his credit, I appreciate Dr. Banov providing an incredibly comprehensive look at all issues relevant to the topic of depression, even if the reader may want more information on the few areas of special interest to them.

In reading this article and possibly reading this book, I hope that the first message you will take away is that depression is real, and it is serious. It is also quite treatable. Antidepressant medication has been in use since the 1950’s and is improving every year. While most people do not like the idea of taking medication, I can tell you that the vast majority of clients I have known who have taken it have found it to be effective and quite easy to tolerate. While they might initially worry that it is not natural or will change their personality in some way, I have heard many a client say “I finally feel like myself” again once the medication kicked in.

As I stated in my introductory paragraph, one of the best things about this book is its emphasis on treatment strategies other than antidepressant medication. If you want a truly unbiased look at the pro and cons, research support and lack of support, you will find it all in this book. If you want tips on how changing your diet can help and specific foods or supplements that might alleviate depression, you will find that information. I think the best piece of wisdom in the entire book is Dr. Banov’s early recommendation to assess your “depression and antidepressant attitude” (p. 15). Take a moment to evaluate any automatic thoughts or assumptions you have about depression and its treatment. Know that this is your bias and that you are likely to be influenced by it now and in the future.  Be on the lookout for when this bias starts to creep in and do your homework to get a fair and balanced perspective.

Here is my bias: I believe that Western medicine has many drawbacks, including a quick-fix mentality and too often a focus on symptoms rather than the cause. When I think about what we ask our bodies to do, given what we put into them nutritionally, I am sometimes surprised that we function at all. I know that my car runs on gasoline, and I never attempt to make it run on water, sugar, sand, or olive oil. Yet, because we can get by eating a diet of processed foods, we often do. I do not know what percentage of depression might be caused by our diets, lack of exercise, spiritual disconnect, etc., but I am guessing a certain number of people could improve their depression by focusing on these aspects of their lives. Some people, however, will also need medication plus these other things to make their lives rich and fulfilling.

I do not suggest that all of my clients consider antidepressants – not by a long shot. I have seen some clients for years before this type of discussion has ever come up. With other clients, it might be mentioned in our first session. It all depends on how much a person is suffering. In many cases, I think it makes sense to try other things first – healthier foods, sunshine, exercise, yoga, social contact, etc. But if your life feels like it is unraveling and the damage is starting to mount up, an antidepressant may very well be the best choice. There is no rule that you can’t do all those other things too. Most importantly, do something to treat your depression. You deserve to feel better.

February 13, 2010

The Five Love Languages

Filed under: 2010 Articles,Molly's Articles,Relationships & Intimacy — karunacounseling @ 6:59 pm
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By Molly Keeton, Ph.D.

The information in this article comes from a book by the same title “The Five Love Languages: The Secret to Love that Lasts” by Gary Chapman.

As I was reading this book, I found myself going back and forth in my response. One second I was thinking “this seems to be surface level sort of stuff – how profound of an impact can it really have?” The next minute, I was truly blown away by the depth of what could be communicated and healed by speaking one another’s love language. In the end, I found the concepts to be meaningful, relevant, and useful. While no one thing is going to be the solution to making love last, I believe this could be a valuable contributor. Learning one another’s love language (and actually taking the time to speak that language) not only offers love to one’s partner in a way that will make them feel the most loved, most secure, and most taken care of but also will convey investment and commitment to the relationship.

When I have come upon earlier editions of this book, I noticed that a very specific religious context was put upon the concepts. This is not the case in the most current version, which I read for this article. If you are looking for Christianity to be incorporated, you may enjoy the earlier edition. I am not certain what this might have added, but I can say that I did not find the book lacking in any way without this lens.

One final observation – I found the language in this book to be disappointingly heterosexist. The author often used the word “spouse” but mostly referred to “marriage”, “husband”, and “wife”. He made no mention of same sex relationships. It is never my preference to recommend a book that does not acknowledge and celebrate same sex relationships; however, I felt the information was valuable and wanted to share it. I also firmly believe that it applies to all people and relationships equally.

Falling in love, falling out of love

Human beings require love and affection. It is one of our most basic needs. The need to feel that we belong and are wanted is essential to the human experience and to our overall emotional health. This begins in infancy and childhood but does not end there. As adults, when we have that all consuming experience of falling “in love”, this need appears to be met in a very fulfilling way. When this happens, we feel as though we have met our soul mate. It is like heaven on earth – we could spend all day together and never run out of things to say. We have more in common with this person than we ever dreamed possible. They are a perfect fit to our best selves, our quirkiest selves, our truest selves. We hardly ever disagree, but when it happens, we are able to move on quickly. In dreaming of the future, we know bigger obstacles will come but are confident that we will triumph over them. Together we can work through anything because our love is special and we are truly committed.

Although our need to be loved is temporarily satisfied by early love, over time the euphoria begins to fade. Studies show that this infatuation stage of early romance can last up to about 2 years (it may last twice that long in the case of an affair) but does ultimately come to an end. “Welcome to the real world”… of partnership… “where hairs are always on the sink and little white spots cover the mirror… where shoes do not walk to the closet themselves… and socks go AWOL during laundry. In this world, a look can hurt and a word can crush. Intimate lovers can become enemies and marriage a battlefield” (p. 30).

We ask ourselves if we were wrong, was our love not the real thing, was it not meant to last? The truth is that it wasn’t meant to last – not the obsession of early love, during which nothing else seems to matter (work, housekeeping, paying bills, seeing friends and family). It is virtually impossible to keep any balance in one’s life during that initial and overpowering stage of love. As such, it is a good thing for the world that it does not go on forever.

The sense of connection during the early “in love” stage gives us a false sense of intimacy. It also gives us a false sense of ourselves – in this phase, we are truly selfless. Giving to our partner is the most gratifying thing on earth. Their faults are easy to overlook. This is made easier by the fact that our partner feels the same way towards us – truly loving and altruistic. However, as life goes on we inevitably return to our own interests and needs and so does our partner. We realize again that we are two people, not one. Two people with different goals, needs, feelings, preferences. We may feel we are falling out of love, and in a way this is true once that all consuming “in love” feeling begins to diminish. At this point, many couples may split. They may believe their only alternative to moving on and hoping to find “the one” is to settle into a life of disappointment with this person who so clearly does not understand their needs. However, one other option does exist – to recognize that the “in love” experience was meant to be temporary and to learn how to have a truly intimate long term relationship with one’s partner. True love cannot really begin until the obsessional love phase has come to its conclusion.

“True love’ …is emotional in nature but not obsessional. It is a love that unites reason and emotion. It involves an act of the will and requires discipline, and it recognizes the need for personal growth. Our most basic emotional need is not to fall in love but to be genuinely loved by another, to know a love that grows out of reason and choice, not instinct… if, once we return to the real world of human choice, we choose to be kind and generous, that is real love” (p. 32-33).

Love Languages

People speak one of five different love languages, usually the language of our caretakers, which we can think of as our native language. Each of the five basic love languages can contain a number of dialects. This means that there are countless ways to express love to one’s significant other while using their love language – the language that will truly make them feel loved. Over time, we may acquire new or different languages, but typically other languages will not come as easily as the primary language we were taught in our family of origin. One’s primary love language is likely to be drastically different from that of their spouse or significant other – possibly as different as English and Chinese. In order to communicate our love more effectively, we must be willing to identify our own love language, the language of our significant other, and to learn to speak one another’s love language.

Love Language #1: Words of Affirmation

Words of affirmation are words that build another up. These are words that express love verbally. They may be complimentary or express appreciation. They are as varied as one’s imagination and may speak to physical appearance (“Wow, are you looking hot tonight!”), a character trait (“You always go above and beyond for the people you love”), or encouragement (“You have both the talent and passion required to become a great artist”).

Encouraging words

This literally means to “inspire courage”, to help build up our partner’s sense of security and self-esteem. This does not involve harassing your partner into doing something that you want them to do but helping them find the courage to pursue what is meaningful to them. It comes from a place of empathy and being able to see the world through one’s partner’s eyes.

Kind words

To truly communicate love verbally, one must use kind words and a tone that matches. This is especially important in the face of an argument. When spoken with kind words, even sharing a disappointment (“I was really hurt that you did not make it on time to dinner tonight”) can build connection.

Humble words

“Love makes requests, not demands” (p. 45). We need to know and understand one another’s desires in order to develop intimacy. Stating those desires as an order, a threat, or an ultimatum will not lead to connection. Sharing our needs and giving our partner a choice in meeting those is a way to guide them. Making a request of your partner indicates that s/he has something to offer, which affirms their worth.

Love Language #2: Quality Time

Quality time involves giving someone else your undivided attention. “When I sit with my”… partner… “and give her twenty minutes of my… time… and she does the same for me, we are giving each other twenty minutes of life. We will never have those twenty minutes again; we are giving our lives to each other” (p. 56).

Focused attention

This is more than just being in proximity or doing something together while paying attention to other things. On the contrary, it is not limited to sitting quietly and looking into each other’s eyes or having hours of conversation about our hopes and dreams. Focused attention may involve an activity that one or both of you enjoy, but the activity itself is almost irrelevant because our intention in doing it is giving our attention to our partner.

Quality conversation

This is a very common love language that involves a true sharing of thoughts, feelings, and opinions in a loving and uninterrupted manner. We are focused on listening and truly hearing from our partner, encouraging them to share more of themselves. This is not likely to involve offering solutions or analyzing what they are saying but being attuned to your partner’s feelings.  You may have to learn to listen to offer this love language, and you also may have to learn to talk – to share openly from your heart and let your partner see inside of you.

Quality activities

These include any activity in which at least one of you has an interest, but again,the emphasis is on the why and not the what of the activity. The meaning behind the activity is to experience something together, to express love by doing this thing together, and to add to your memories of meaningful time spent together.

Love Language #3: Receiving Gifts

“At the heart of love is the spirit of giving. All five love languages challenge us to give to our spouse” (p. 82). A gift is a tangible thing that can be given, a symbol of one another’s love that can be seen and felt. Giving someone a gift involves thinking of them, and the gift becomes symbolic of this thoughtfulness. For people who speak this love language, having a visual symbol of their partner’s love is incredibly meaningful. Gifts may be bought, made, or found. The value of the gift or the money spent is not the key component here. It rarely matters what the cost of the gift is unless it is thought to be very far outside of what one can afford (in either direction).

If receiving gifts is the primary love language of your partner, you may have to alter your beliefs about how money should be spent. If gift giving seems frivolous to you, think of creative ways to give that don’t involve too much money. And when it comes to the times that money needs to be spent, think of it as an investment in your relationship.

Also, be aware that the gift of self can be powerful, especially for those who see love in visual ways. Giving of yourself by being present during a special event or a time of difficulty may speak volumes to your partner.

Love language #4: Acts of Service

To do an act of service is to do something for your partner that you s/he would like to have done. Acts of service “require thought, planning, time, effort, and energy. If done with a positive spirit, they are indeed expressions of love” (p. 92). Acts of service could include doing the dishes, getting the tires rotated, hanging a picture, cleaning the litter box, paying bills, or making a call to the mortgage company. Oftentimes, this doing for one another is a regular part of the “in love” phase but fades out once a long term relationship begins.

Doing acts of service does not mean to become a slave or a doormat. It is not to become a servant or to give in to manipulation, coercion, guilt, or demands. It means giving to our partner through taking on some of the tasks of daily life and expressing one’s love by relieving your partner of that particular burden. Getting comfortable with giving acts of service may require re-examining what you learned about what it is to be a man or a woman in a relationship and letting go of some outdated stereo-types (you may find their effect whether you are in an opposite or same sex relationship).

Love language #5: Physical Touch

“Whatever there is of me resides in my body. To touch my body is to touch me. To withdraw from my body is to distance yourself from me emotionally” (p. 112). The sense of touch is incredibly powerful for human beings. Many studies have shown that babies who are affectionately touched more often are physically stronger and more resilient and grow up to be emotionally healthier.

Unlike the other senses, touch is not limited to one part of our body.  Physical touch can communicate a variety of things – love, hate, tenderness, aggression. For a person who speaks this as their primary love language, touch may communicate far more than words ever can. The dialects are also infinite in the language of physical touch – what one person finds meaningful may do little for someone else. You must learn to speak each other’s dialect when it comes to physical touch and never assume that what feels good or loving to you applies equally to your partner.

Loving physical touch can be explicit or implicit. Explicit touch requires effort and attention (a massage or sexual interaction). Implicit loving touch may take less time and effort but does require thought and intentionality. This could be sitting close to one another, touching them as you pass by, giving a quick kiss when saying hello, or holding hands as you walk together.

Sex may be a primary dialect within this language, but not all need for physical touch should be assumed to be sexual. Also, a strong and frequent desire for sex does not necessarily mean that physical touch is one’s primary love language. If you find little meaning or interest in being physically affectionate outside of sex, then physical touch is not likely to be your primary love language, even if your craving for sex is quite intense.

Identifying your love language

Just reading the brief descriptions of the five languages may have clearly illuminated to you what your primary love language is. You may or may not be able to guess the language of your partner as well. If you would like to do a more formal assessment, there are questionnaires in the book. Another option that Chapman recommends is reflecting on the following questions:

  • How do you most often show love to others? When you want to express to someone that they mean a lot to you, do you find yourself doing nice things for them (acts of service) or writing them a note to tell them how much you care (words of affirmation)?
  • What have been your typical complaints to your partner within your relationship? Do you find yourself expressing frustration over not spending enough time together (quality time) or wishing s/he would do more to help around the house (acts of service)? These complaints will shed light on your unmet needs. And if you are not sure of the answer to this question, ask your partner. They are very likely to know your complaints.
  • What do you ask your partner for most often? Do you find yourself asking for a backrub or hug (physical touch), for a token of their feelings (gifts), or for encouragement when you want to pursue something (words of affirmation)?

March 3, 2009

How Trauma Affects the Brain

Filed under: 2009 Articles,Abuse & Trauma Recovery,Molly's Articles — karunacounseling @ 3:19 pm
Tags: , , , ,

 

 

triune_brain_image

By Molly Keeton, Ph.D.

Trauma is a word that we use and hear often, but what is trauma? It is usually defined as the experiencing or witnessing of an event(s) that is threatening or dangerous and out of one’s control. Trauma usually involves a feeling of helplessness. Many people serving in the military experience trauma, as do individuals who survive a natural disaster, serious accident, or personal assault. While these are common examples of trauma, experts generally agree that what makes something traumatic to a person is determined by their response to it, rather than whether someone else considers it “traumatizing”. For example, a student who was humiliated by a parent or teacher while growing up may have experienced a trauma.

The best way to determine if an event was traumatic in your life is simply to look at the impact it has had. Do you continually think about the event, even when you do not intend to? Do you sometimes experience the feelings that you felt during the event or even feel as if you are experiencing the trauma again? Do you avoid reminders of the event by steering clear of certain places, people, or topics of conversation? Do you have nightmares related to that event? Do you find yourself on edge, expecting danger, or responding differently than others to certain events (for example, a veteran may hit the floor when they hear a car backfire, thinking that it is a gunshot. Or a woman who has survived sexual assault may be untrusting of all men)?  Are these symptoms getting in the way of your relationships, goals, sense of peace and safety, or general life satisfaction? If you answered yes to even a few of these questions, you may be dealing with Post Traumatic Stress Disorder (PTSD), an anxiety disorder that may occur after a traumatic event. While these responses are normal and expected after a trauma has been experienced, PTSD occurs when they go on for weeks, months, or even years after a trauma. 

Trauma can have dramatic and long reaching effects on an individual’s life. Learning more about the neurological processes involved may provide information about why trauma impacts us the way it does, increase empathy for oneself and/or others, and promote awareness that healing can occur.  

 

Development of the human brain

The human brain contains three distinct parts that developed in this order: the reptilian brain, the mammalian brain, and the cortex (or neo-cortex). Higher level functions, such as planning, developed later than the more primitive capacities, such as aggression. 

The reptilian brain

The oldest and most primitive part of the brain. Primary task is survival. Controls breathing, balance, and temperature regulation. Acts out of instinct.

The mammalian brain

Includes the limbic system, which is the emotional center of the brain. Involved in the control and expression of emotion, the body’s response to danger, and the processing of short term memory. Primary focus is also survival.

The cortex (or neo-cortex)

The most recent area to develop within the brain. Allows for higher level thinking, analysis, logic, and intellectual pursuits. Cortex is always overridden by reptilian and mammalian brains.

                        

triune_brain_image

(From http://website.lineone.net/~bryn_evans/Triune_Brain/triune_brain.htm)

Despite how humans have evolved, the primary task of the brain remains self-preservation and propagating of the species. The functions of the reptilian and mammalian brains will always override the neo-cortex, as our very survival is dependent upon this. Because threat has a far more immediate and powerful consequence than reward, the brain is overdetermined to sense and respond to danger.

The brain receives data from the outside world through the five senses. This sensory information comes in through the thalamus and is directed either towards the limbic system or the cortex. If threat is perceived, the sensory input goes first to the brainstem and midbrain (limbic system). In this case the limbic system attempts to match the data against information and patterns that have been stored from past experience. If threat is perceived or if the data matches a template for danger, the alarm response of the brain is activated. The limbic system is quite complex and contains many different structures. For our purposes, we will focus on two of these structures: the amygdala and the hippocampus.

 

The Amygdala

The amygdala is the part of the limbic system responsible for processing and assigning emotional value to incoming sensory information. It is a tiny, almond shaped structure at the core of the limbic system. It is over 50,000 years old and was designed to protect us from threats such as a saber-tooth tiger. The amygdala functions sort of like a pass-fail exam. When trying to decipher between something that might bring pleasure and something that might bring death, every piece of sensory data must be quickly sorted into only one of two categories – safe or unsafe.

If the amygdala perceives a threat, it immediately springs into action and does not wait around for the cortex to analyze the data and return a verdict (i.e. “that man reminds me of someone dangerous because he has a similar hairstyle, but he is very clearly not the person who hurt me in the past). Although the limbic system and cortex have many interconnecting neurological pathways, communication to the cortex may be cut off in this moment of danger. When the potential for severe injury or death is imminent, there is simply no time to stop and make logical evaluations or interpretations. Remember that this system evolved to protect us from tigers and other such predators. It would be a waste of precious time if in the midst of being charged by a tiger one stopped to compare it to other tigers in that region, estimate its size or velocity, or begin planning the best strategy for escape.  

Before any conscious awareness has occurred, the amygdala activates the Autonomic Nervous System (ANS), which enlists every area of the brain and body to respond to the threat and deactivates all non-crucial bodily functions, such the digestive and immune systems. The amygdala also determines the best response to a threat, including the fight, flight, and freeze responses. If the limbic system perceives that there is enough strength to defend oneself, then fight will be chosen. If adequate time, strength, and distance to allow for escape is perceived, then flight will be chosen. In both cases it is the sympathetic branch of the ANS that responds, resulting in increased respiration, heart rate, oxygenation of the blood, and blood flow to the muscles for mobility and strength.

If time, strength, and distance are not determined to be sufficient or if death could be imminent, then the parasympathetic nervous system is activated. This branch is associated with resting and relaxation and leads to the freeze response.  This can be seen in nature when a mouse being attacked by a cat goes limp, oftentimes resulting in the cat losing interest and the mouse surviving.  As a teen I participated in a 3 week wilderness course where I was given similar advice. If I encountered a bear and was within close enough range to see it, there would be no way for me to outrun that bear. Outfighting it was obviously out of the question. My best defense would be to drop to the ground and hope that it would get bored of me before inflicting too much bodily harm.  This is VERY important information if you are a person who ever blamed yourself for how you responded to a trauma. Your reaction was not a thinking process and was not up to your conscious mind. It came from an instinctive part of your brain that is very, very old and very well programmed to protect you from any avoidable danger.

 

The Hippocampus

The hippocampus is a structure in the limbic system that is associated with learning and memory. The hippocampus stores memory of time, place, and space in time. It organizes memories in a chronological way. Because of the heavy activity of the Limbic and autonomic nervous systems during a traumatic event, traumatic memories are believed to get stuck in the lower and mid portions of the brain (reptilian and mammalian brains) where they cannot be accessed by the frontal lobes of the neo-cortex. While normal, non-traumatic memories get filed away in various places of the cortex, traumatic memories are not processed or integrated in the typical way.  

While this may seem like a cruel joke of nature, there is a good biological reason for it. When the limbic system perceives a threat, it activates the ANS to release hormones to enhance the fight, flight or freeze response. These hormones not only activate the body to physically respond but also supercharge the memory function of the brain (it should really only take one run in with a shark for the body to imprint that this is a dangerous situation). The amygdala is basically sending a strong message that whatever just occurred needs to be remembered and remembered very well. In this state of arousal, the body continues to release hormones such as adrenaline, which, over time, can damage connections within the brain (it can also cause damage to the heart and the immune system). Research has also shown that adrenaline can ultimately shrink the hippocampus – further reducing its ability to place memories in time and space.

The brain is constantly in the process of receiving data, interpreting and analyzing it, and creating action based on that data. It has an enormous capacity to store information and use that information over time. The human brain increases its efficiency by creating internal representations of the external world, or templates. These associations generalize to future events. For example, when I see a door, my brain instantaneously recognizes this and sends a message to my muscles about how to respond. From time to time I may come upon a door that looks nothing like any door I have ever seen in the past, but still my brain can compare it against the template it holds for doors and respond appropriately. This is true of all sensory input, whether it comes in through site, sound, smell, taste, or touch. The sense of smell has been found to make particularly powerful associations in the brain. This is especially evident with Post Traumatic Stress Disorder (PTSD) – oftentimes a familiar scent can trigger the autonomic nervous system faster than anything else. (If you look at a diagram of the brain, you will notice that the olfactory bulb, which is responsible for sense of smell, is located within the limbic system).

 

Brain Plasticity

The brain is modified by all experiences, whether they be positive or negative. This is because it has plasticity, meaning that its architecture and pathways of communication can be modified over time. Some areas of the brain, such as the cortex, have more plasticity than others. It is relatively easy to learn the concepts being presented in this paragraph (cortex) but quite difficult to learn to ride a unicycle (reptilian brain). The brain develops and is organized in a use-dependent fashion. It is commonly accepted that “neurons that fire together, wire together”, so the more a neural system is activated and used, the more it will adapt over time. The greater the activity within a neural system, the more the system will develop capabilities related to that type of function. This is true for playing the piano, learning a second language, or responding to a threat – more “practice” means the response becomes more engrained. Once a brain area is organized, it is has less plasticity and is less receptive to incorporating new data (again, it is harder to learn to play the piano as an adult than as a child).

 

Post Traumatic Stress Disorder

The activation of the autonomic nervous system (increased heart rate, blood pressure, respiration, etc) in response to danger is a normal, adaptive, and protective biological function. However, PTSD may occur when the ANS continues to engage once the threat is no longer present, leaving the body in an active state of arousal. This may occur if trauma is ongoing, as in repetitive abuse throughout childhood, or when a person is somehow unable to return to a sense of homeostasis and calm after exposure to trauma.

When the brain stores a memory within the limbic system instead of processing through to the cortex, it seems to just float in the hippocampus so that it can be easily accessed. To set the ANS in motion, the amygdala requires only a 10 to 20 percent overlap between a template for danger and a current sensory cue. This is why a seemingly innocuous cue (such as the smell of smoke for someone who has survived a fire) can send the body into fight, flight, or freeze mode. In some cases, a person may be responding to a cue that they are not consciously aware of, such as the slump of another person’s shoulders. Due to the mind-body connection, the amygdala may also interpret danger when the ANS is aroused for some other reason. For example, if heart rate was elevated during a traumatic event, later acceleration of the heart rate (while exercising) can signal danger to the amygdala.

From the standpoint of survival, it is preferable for the brain to over generalize signals of danger than to under generalize. But emotionally speaking, this can wreak havoc on a person’s life. Traumatized individuals may be more vulnerable to making false associations and interpreting danger in an environment where none exists. Due to plasticity, the more the autonomic nervous system is engaged, the more this pattern becomes ingrained. The more this pattern is ingrained, the more the ANS will be set off. This is the cycle of living with PTSD. In addition, an experience that sets off the body’s alarm response can alter the sensitivity of that alarm response. Over time, even non-sensory cues (remembering the event) can signal the amygdala and lead to an emotional response of fear.

 

Brain Plasticity – the good news

Although the brain has less plasticity as it ages and organizes, it can always be altered in significant ways. It is possible to re-train the Limbic System to become less reactive, meaning living with less fear and being triggered back to a trauma less often. Current research is finding that the most effective therapies for clearing trauma involve not emotionally reliving or re-experiencing the trauma but just the opposite. To help move traumatic memory out of the Limbic System, a person must be able to revisit the trauma without activating the Autonomic Nervous System. New methods for working with trauma effectively are constantly being discovered. Some of these methods may have a client talk through aspects of the trauma while keeping the Limbic System calm (clinical hypnosis, Rapid Resolution Therapy). Other methods, such as EMDR and EFT use eye movements or tapping on acupressure points to help the body release the trauma. It is believed that all effective trauma treatments work on a neurological level by creating new neural pathways within the brain. If you are dealing with an unresolved trauma, I encourage you to talk with your therapist about some of these and other techniques.

When traumatic memories get triggered and the ANS becomes activated, there are ways to help calm your system. Just focusing intently on the breath can be extremely helpful (please see the breathing exercises on the front page of this newsletter).  Activities that help to redirect you away from your emotions and towards purposeful relaxation of the body, such as yoga or Tai Chi, can also be effective. Sometimes doing a physical task can not only redirect your thoughts and feelings but also help to engage different parts of the cortex. This could be gardening, artwork, or something mechanical. Tasks that use both hands may be especially effective because they engage both sides of the brain. Many people with PTSD have found that practicing mindfulness and meditation can also reduce their symptoms. While it may be difficult to get into a meditative state once the ANS is activated, regular meditation is one great way to alter the limbic system’s level of reactivity. 

 

In Conclusion

I hope that the information in this article has been informative and that in understanding the brain better, you will have greater compassion for the impact trauma has had on your life or the life of someone you know. If you find that reading about this topic is emotionally challenging, I encourage you to speak with your therapist. If you are not currently in therapy but are interested in starting this process, please consider contacting Karuna or any other therapist for an appointment. 

 

 

 

Resources:
National Center for Post Traumatic Stress Disorder
http://www.ncptsd.va.gov/ncmain/index.jsp

The National Institute of Mental Health
http://www.nimh.nih.gov/health/topics/post-traumatic-stress-disorder-ptsd/index.shtml

 

EMDR
http://www.emdr.com/

EFT
http://www.emofree.com/

Rapid Resolution therapy
http://www.rapidtraumaresolution.org/

 

Book Recommendations

As a general rule, it is best for trauma survivors to avoid reading passages containing explicit description of other people’s trauma. Such material can unnecessarily trigger one’s own trauma experience. Be cautious, and feel free to step away from any reading that causes discomfort. If you believe that the material is worth learning about, please discuss it with your therapist or consider having a friend or partner read the information and relay the important aspects to you.  

Caring for the Child Within — A Manual for Grownups

By Jane Rowan

http://www.janerowan.com/ChildBooklet.htm
 

Outgrowing the Pain: A Book for and About Adults Abused As Children

by Eliana Gil (Author)

http://www.amazon.com/Outgrowing-Pain-Adults-Abused-Children/dp/0440500060/ref=sr_1_2?ie=UTF8&s=books&qid=1235746985&sr=1-2

Outgrowing the Pain Together

by Eliana Gil (Author)

http://www.amazon.com/gp/offer-listing/0440503728/ref=sr_1_olp_1?ie=UTF8&s=books&qid=1235746985&sr=1-1

An Adult Child’s Guide to What’s ‘Normal’

by John C. Friel Ph.D. (Author), Linda D. Friel M.A. (Author)

http://www.amazon.com/Adult-Childs-Guide-Whats-Normal/dp/1558740902/ref=sr_1_1?ie=UTF8&s=books&qid=1235747061&sr=1-1

The Sexual Healing Journey: A Guide for Survivors of Sexual Abuse (Revised Edition)

by Wendy Maltz (Author)

http://www.amazon.com/Sexual-Healing-Journey-Survivors-Revised/dp/0060959649/ref=sr_1_1?ie=UTF8&s=books&qid=1235747192&sr=1-1

November 10, 2007

Emotional Eating During The Holiday Season

By Andrea Schrage, MA, LAPC,CMT and Molly Keeton, Ph.D.

The holidays are an emotional time and often a time of overeating. As family and friends come together, food is often the focus of celebrations. Below are some tips to think about during holiday dining. Allowing yourself to enjoy food during the holiday season is a great option when it is a conscious choice.

Ask yourself if you are hungry.

Take a breath before reaching for food.

Ask yourself how you feel in that moment.

Imagine tasting the food in front of you and decide

if it is really what you want.

When allowing yourself to indulge, plan some limits ahead of time.

Drink plenty of water.

Don’t skip meals to make up for too many sweets.

Be compassionate with yourself and your choices.

Eat regular meals and healthy snacks to avoid being over-hungry.

Prepare a list of alternatives to eating.

Make healthier versions of favorite recipes.

Make room for emotional support.

Read this list before going to events.

Remember that most often finding a balance in life is a healthy goal to obtain.

September 4, 2007

Choosing A Career That’s Right For You

by
Molly Keeton, PhD

When making a career choice, you must have knowledge of both yourself and the world of work. When you allow for exploration of both of these areas, you will be more likely to make an informed choice, select a career that is a good fit for you, and have greater work and life satisfaction.

In learning about yourself and the world of work, consider each of the following areas. The ideal career will be a match for these important aspects of your life and identity. You would be fortunate to find a career that is compatible with who you are as a person and allows you to express yourself through the work you do everyday.

You World of Work

Interests Job characteristics

Skills Working conditions

Values Training/Educational Requirements

Personality Necessary skills and abilities

Goals Work environment

Ideal lifestyle Job outlook and opportunity

1. Interests

When considering your career interests, think back on all of the things you have experienced in your life. Which work experiences have been the most rewarding to you (include part-time jobs and volunteer work)? What hobbies do you enjoy the most? Which classes did you like or dislike in school? What do you like to do with your free time? What activities make you feel the best or bring out the most in you? What do you do where you don’t even notice that time is passing? Allow yourself to think freely when considering your interests. There are over 26,000 jobs in the world and there are probably several that could combine your favorite activities and/or hobbies.

According to a psychologist named John Holland, career interests can be classified into six basic types. You can learn about this classification system in a more formal way through a career inventory, but this will provide you with an overview of the basics. Try to determine your type by choosing three of the six categories and place them in order of importance to you. Once you determine this, you can do more research on careers for your type at http://www.careersmarts.com/holland.htm.

Realistic

  • Generally likes working with their hands and producing something tangible
  • Enjoys nature and working outdoors
  • Prefers independence and working alone or in a small group
  • Prefers facts to feelings
  • Examples: mechanic, construction work, wildlife management, laboratory technician, agriculture, some military jobs, engineering

Investigative

  • Always asks “why”; is intrigued by how things work
  • Enjoys solving problems and examining the underlying cause of things
  • Communicates factually rather than focusing on feelings
  • Prefers independence and privacy
  • Examples: design engineer, biologist, social scientist, research laboratory worker, technical writer, physicist, or meteorologist

Artistic

  • Values creativity; express selves through work or artistic medium
  • Prefers work setting that allows for individual expression and creativity
  • Views self as independent, unconventional, expressive, and unique
  • Examples: painter, sculptor, writer, composer, cartoonist, singer

Social

  • Gains satisfaction from helping others and making positive impact
  • Enjoys solving problems through interaction and discussion of feelings
  • Works well others
  • Examples: teacher, counselor, speech therapist, clergy, playground director, social worker

Enterprising

  • Enjoys debating and persuading others; has way with words; is influential
  • Natural sales people (may sell may either a product or an idea)
  • Values leadership, prestige, and status
  • Examples: business executive, attorney, politician, hotel manager, television producer, sports promoter, realtor

Conventional

  • Enjoys activities that require attention to detail
  • Values accuracy and consistency
  • Prefers highly structured work environments and clear expectations
  • Examples: bank teller, bookkeeper, computer operator, tax expert, statistician, traffic manager, librarian

2. Skills and Abilities

Skills are learned while abilities are natural to us (learning to play golf well would be a skill, while being good with numbers is typically an ability). Generally speaking, we enjoy the things we are good at and are good at the things we enjoy. So, reflecting on your favorite activities will provide important information about your skills and abilities. Again, think back on classes, activities, hobbies, and jobs from the past. Is there any overlap between the ones you liked and how natural those abilities came to you? You can certainly choose a career that does not utilize your natural abilities, but you may find that it is more of a challenge to do that type of work.

3. Values

A third area to consider when making a career choice is your value system. Values include: prestige, status, autonomy or independence, flexibility, variety, security, high salary, creativity, challenge, advancement, physical activity, or contribution to society. It is important to be honest with yourself about your values and recognize that no value is “right” or “wrong”. We all have a different combination of values that make us unique. How we express these values is also very individualized. One person may give back to society by working with the homeless while another may contribute through volunteer work or making a regular donation to a charitable organization. Take this list of 12 values and prioritize it. You will probably find that you want almost all of these things in your life. To get more information about your priorities, pick your top 3 values. These will be the ones that you feel you cannot compromise.

4. Personality

This is another very important area to consider when making a career choice. You will often find that personality traits will overlap with interests or values, but they can be separate too. The most well known personality inventory is called the Myers Briggs Type Indicator, and it has been researched over several decades. This inventory looks at four personality factors:

Extroversion vs. Introversion

(Where you get and prefer to direct your energy)

Sensing vs. Intuition

(How you take in information)

Thinking vs. Feeling

(How you make decisions)

Perceiving vs. Judging

(How you relate to time, structure, and organization)

These qualities exist on a continuum, meaning that you will fall somewhere in the middle of each set of traits. Very few people are complete extroverts or introverts. Most of us prefer one to the other but can do both when necessary. When you step outside of your natural preference, it may be more challenging and you may feel tired or strained. Finding a work environment that matches your personality type will lead to greater work satisfaction. Consider the following: Would you rather work alone or with a team? Do you prefer clear answers or to find new solutions? Do you want structure and predictability in your workday or do you enjoy the unexpected?

For a free Myers Briggs personality inventory, visit www.humanmetrics.com/cgi-win/JTypes2.asp. Once you have this information, you can do research online about how this relates career. Begin by visiting www.personalitypage.com and searching the personality and career link for your Myers Briggs Type.

* For additional information, check your library or the Web for more career resources:

http://online.onetcenter.org (Dictionary of Occupational Titles)

http://stats.bls.gov/oco/ (Occupational Outlook Handbook)

August 20, 2006

Boundaries

by Molly Keaton, PhD

What is a boundary?
All life forms have boundaries and each part of our bodies has physical limits, from the skin to the membranes covering nerves and muscles. When our physical boundaries are invaded (when we are cut or scratched) we are vulnerable to infection. Therefore, our physical boundaries promote health and safety. My physical boundaries are defined by how close I let people get to me. My emotional boundaries are defined by how I allow others to interact with me – whether I tolerate abuse and hostility or whether I demand respect.

To learn more about your boundaries, think about the amount of personal space that you prefer. You can probably recall the creepy feeling that arises when someone (especially someone you don’t know well) invades your comfort zone. Also, notice that this zone is very different with strangers than with acquaintances. We allow those that we love and trust to get much closer, but still there is a difference in what is acceptable for a friend vs. a lover. This illustrates an important point about boundaries – they are flowing and adaptable. It is our right to choose where to set the boundary of how close another can get to us physically or emotionally. This limit will change not only based on the relationship but also based on the situation. For example, in a relationship, there are times when partners feel like being sexual and times where they do not. Just because you are sometimes physically intimate with a partner does not mean that you owe this to your partner at all times. It is your right to set boundaries, to change your mind about those boundaries, and to have those decisions respected.

Where do boundaries come from? Why do I need them?
Boundaries define who we are and how we are connected and separate from others. Boundaries give us a sense of order and control over our lives. Healthy boundaries are empowering in that they set limits on what we will and will not tolerate from others. They allow us to bounce back from situations in which our limits are violated through awareness of our own needs and how to defend those needs. Empowerment comes not only from knowing how to protect ourselves but also from knowing that we will protect ourselves.

Boundaries develop throughout the course of our lives, beginning with our earliest interactions with the world. Our caretakers can promote healthy boundaries through encouraging individuation, which is the process of developing a clear identity that is separate from the identity of the caretaker. Conversely, a caretaker can also encourage non-existent or unhealthy boundaries. Unhealthy boundaries come in a variety of forms – boundaries can be set both too close, resulting in enmeshed boundaries. Enmeshment occurs when our uniqueness and individuality are not respected. Enmeshed families demand that all members exist for one another and sacrifice themselves in the interest of sharing the same beliefs, values, and opinions. However, boundaries can also be set too far away, resulting in little connection with the outside world. In order to determine where are boundaries are, we have to get close enough to others to feel their presence. We learn about our limits by testing them.

Childhood experiences, most significantly from caregivers, teach us where our boundaries lie and how to treat those boundaries. Enmeshed families promote the idea that boundaries do not exist and that to develop personal boundaries is to betray the family. Distant families teach their children that they are alone, isolated beings with nothing to lean on for support in this huge world. While we learn about our boundaries from our caretakers, we educate others about our boundaries through the way that we allow ourselves to be treated.

Healthy emotional boundaries lead to greater emotional health. Boundaries allow us to take care of ourselves and to defend our own beliefs, values, and needs. Boundaries allow us to say “No” to others and to act in our own best interest. Boundaries allow us to give to others without sacrificing too much of ourselves. Boundaries are highly individualized – they can be firm or flexible, close, or distant. They also vary by country and culture. Good boundaries necessitate attention and maintenance.

How do you know where your boundaries are?
When our physical boundary is violated our emotional boundaries are also transgressed. Our physical and emotional boundaries work like a system of checks and balances. Without each, we are vulnerable to violations. Our responses and emotions provide feedback about our comfort in a situation. This feedback allows us to take an inventory and as a result, to gain greater self-understanding. The combination of feedback and self-awareness facilitates boundary development. If we receive feedback but do not listen or respond to it, we are violating our own boundaries. If we do not react to our emotions, we send the message to ourselves that our feelings and gut responses are not important or reliable. In doing this, we risk losing our best tool for judgment by disconnecting from our feelings and relying on others to define our limits.

Boundaries promote connection.
Not only do good boundaries limit harm, they also increase intimacy. The ideal relationship (be it romantic or friendly) promotes a strong sense of “us” while allowing each partner to be distinct enough to maintain her/his own identity. Healthy romantic relationships involve a commitment where two people choose to make a life together. This choice is not based on dependence or enmeshment – both partners could survive without the other. While enmeshment or infatuation may resemble intimacy, they are not. Enmeshment occurs when there is no boundary or individual identity in place. Enmeshment is loving the idea or image of another rather than that other’s true self. Intimacy occurs when two people know each other deeply, accepting both strengths and limitations. Intimacy means being able to accept that your partner is distinct and has her/his own ideas, values, beliefs, and goals. Intimacy comes from having faith that you are known, accepted, and valued for who you truly are.

In sum, the goal is “to form boundaries that have some flexibility and some definite limits, boundaries that move appropriately in response to situations – out for strangers, in for intimates. Boundaries should be distinct enough to preserve our individuality yet open enough to admit new ideas and perspectives. They should be firm enough to keep our values and priorities clear, open enough to communicate our priorities to the right people, yet closed enough to withstand assault from the thoughtless and the mean” (Katherine, 1991, p. 81).

The information in this article came from a book entitled Boundaries: Where You End and I Begin (Anne Katherine, 1991).

April 9, 2005

Gay, Lesbian, and Bisexual Identity Development

By Molly Keeton, Ph.D.

Recently, there have been several articles on the Karuna web page about the coming out process. This article will look more in depth at the various stages of recognizing, identifying, accepting, and sharing non-heterosexual identity. I will be using the work of researchers within the field of psychology (Troiden, Cass, Coleman) who have attempted to summarize this process and identify its most common elements.

A model or summary can provide a framework for your experience(s), which helps to show that you are not alone and that your struggles have been an inherent part of the process, rather than some sort of personal inadequacy or weakness. However, it is very clear that not everyone’s experience can be fit into a model. In reading about these stages, keep in mind that they may or may not exactly apply to your life experience. If it is not helpful or comfortable for you to compare yourself to these models, then don’t. By no means should these models be used to stereotype, stigmatize or pathologize any individual’s process.

The models of GLB identity formation assume that identity development occurs through several stages over a period of time that varies by person. Identity development is a fluid process, and not all people will go through every single stage or go through them in any particular order. Although the lower stages generally must be achieved before the higher stages, not all people start at stage I. Also, GLB individuals are unlikely to go through these stages in a linear fashion. In fact, you might imagine the process more like a spiral lying on its side. As you move forward along the spiral, you will be cycling back through old stuff. So, individuals can cycle back through earlier stages at any time or even be in more than one stage at one time. For example, even a person who generally feels positive, accepting, and proud of their sexual orientation (stage IV) may have moments of shame, doubt, or fear of discovery (stage II).

Stage I – Sensitization

This first stage of non-heterosexual identity formation generally takes place before puberty. Oftentimes, GLB people look back on childhood and say they always just felt “different” or like they didn’t belong. Later they might attribute this to being gay/bisexual, but most do not identify it as such at the time (one study showed that only 8% of participants labeled them self as gay/bisexual during childhood). Sometimes this sense of not belonging can lead to childhood depression, anxiety, acting out with behavioral problems, physical illness, or even suicidal gestures.

Stage II – Identity Confusion

In the second stage, the GLB individual begins to identify and label their feelings as gay, lesbian, or bi-sexual. Because they always before assumed that they were or should be heterosexual, they may have difficulty reconciling this conflict. They may have a sense of cognitive dissonance, where their feelings or actions do not match their earlier beliefs (that they are straight, are supposed to be straight, or will be damned for not being straight). Just as the individual is beginning to get in touch with his/her true feelings, s/he is also coping with the stigma about being GLB, not having many positive GLB role models, and being surrounded by misinformation about GLB individuals. In stage II, the individual must begin to let go of the old identity or belief system before s/he has fully formed a new identity, which can be like letting go of one trapeze while falling through the air and waiting for the next trapeze to fly your way.

Given the obstacle of this, GLB individuals use different coping strategies while in stage II. A typical response is “denial,” or refusing to acknowledge GLB feelings or desires. They may also use “repair,” or attempting to get rid of the GLB feelings (it is in this stage that individuals might try to convert back to heterosexuality. Some may even seek conversion therapy, which is discriminatory and not condoned by the American Psychological Association). Another strategy for coping with GLB feelings includes “avoidance.” Avoidance can come in a variety of forms, such as trying to inhibit sexual feelings; avoiding any reminders of sexual attraction; avoiding the opposite sex so no one will notice their lack of interest; displaying homophobic attitudes to fool themselves or others; or abusing substances as a way to escape. A fourth basic strategy happens when one “redefines” their feelings/actions as isolated events or an experimental phase. Lastly, a GLB individual may >“accept” their non-hetero thoughts/feelings and begin the process of gathering positive information and support (stage III).

Stage III – Identity Assumption

Gay, lesbian, and bisexual people make several crucial transitions in stage III. They begin to replace past negative beliefs about their sexuality with more positive and accepting ones. This is also a time of exploring the new culture(s), sexual experimentation and/or first relationships, and trying on of new roles, behaviors, and self-perceptions.

Initial experiences with other GLB individuals can be very influential. Negative experiences may lead to further denial of the GLB identity and ongoing homophobic attitudes. Negative experiences can also lead to means of coping that are not always constructive, including “capitulation,” or avoiding all same sex activity;“minstrelization” or adopting highly stereotypic behavior; “passing,” which leads to the stress of living a double life; and/or “group alignment,” or avoiding all reminders of heterosexuality by limiting involvement only to GLB communities.

On the other hand, positive experiences in stage III allow GLB individuals to learn about the GLB cultures and communities while finally finding a group to which they can belong. This may be the first exposure to positive GLB role models, who can teach healthy strategies for managing homophobia, encourage integration of the GLB identity with other identities (ethnic, cultural, religious, ability status, etc.), confront the tendency to see oneself only in a sexual way, and encourage pride.

Stage IV – Commitment

In this stage the individual comes to a greater acceptance of and comfort with their GLB identity. This stage is also sometimes called “integration” and is seen as a time when all identities are integrated into one self-image (for example, “I may be gay, but I am also a Catholic, a father, an attorney, and a republican). With this stage comes a greater sense of empowerment, satisfaction, pride, contentment, higher self-esteem, and more successful romantic relationships.

Because homophobia will continue to be a part of life for the gay, lesbian, bisexual person, 3 new strategies may replace past means of coping with stigma. These include “blending,” which occurs when the individual neither denies nor confesses their GLB identity. They may simply view this as irrelevant to certain situations and elect to not make it an issue. The second strategy is that of “covering,” or being out of the closet in some circumstances/social groups while concealing it in others. Given the potential danger in some situations, covering is an adaptive and, at times, necessary strategy. The third strategy is “converting,” where non-heterosexuality is seen as a valid lifestyle that evokes pride. Homophobia is recognized as a form of social oppression, and the individual works to educate the public in attempt to break down stereotypes and decrease discrimination.

November 1, 2004

Handling the Holidays..in a New Way

By Molly Keeton, Ph.D.& Andrea Schrage, MA, LAPC,CMT

The time is coming..food, festivities, and family. This can be a combination for fun or it can be a recipe for the blues. The following is a few ideas for shifting the holiday “shoulds”.

We tend to follow the same traditions every year because, in theory, it gives us some comfort and connection. This year take some time before hand to evaluate which traditions are truly enjoyable for you. This includes who you spend the holidays with, what traditions you participate in, how much time you spend with others and how much time you spend alone. What would your ideal holiday look like? Be creative. Does it include friends, volunteering, staying at home with relatives? If you do spend time with family, how much time is enough time before you find your self needing some space? Forcing yourself into too much togetherness can create resentment that may go outward or turn inward Either way you are not helping yourself or those around you.

When making plans to change holiday traditions, be prepared for responses that you are likely to receive. Does your family use guilt or coercion to keep things at status quo? Anticipating the tactics that might be utilized can help you to plan in advance how to respond without getting caught up in old patterns. It might be helpful to discuss this with your therapist and to use role-play to get feedback on your approach. Talking to your family about your plans in advance is
preferable to discussing it during the holidays when the emotions are high.

It is important to remember that we are adults now and get to make our holidays what we want them to be. Keep in mind that when interacting with our families, it is easy to revert back to childlike ways of coping. Though these patterns kept us safe when we were younger, they currently keep us engaged in the dysfunctional system. Chances are you are in a space in your life in which you don’t solely rely on your parents for food, shelter, support, and love. Therefore you have more opportunity to make your own choices without threat of losing your foundation.

Making changes can cause temporary stress even though the long-term gains are helpful. To soothe your discomfort, try some of the following: take a hot bath, call a friend, treat yourself to a massage, write in your journal, allow yourself a day off from your to-do list, wrap yourself in a warm blanket, or make yourself a nourishing meal.

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