This is a great self-help book for anxiety!
Friday, January 27, 2012
Tuesday, January 17, 2012
Therapy and Eastern Religion
As I mentioned in the post, Near Death Euphoria and the Link to Suicide, I love www.Reddit.com. On this site, a member asked me about the connection between CBT and Eastern Religions. This was my response:
So, there have been three "waves" of CBT. The first was behavior therapy, the second was cognitive behavior therapy, and the third is mindfulness/meditation related.
The Third Wave CBT approaches are very tied into Eastern religion. The names of the most well known Third Wave approaches are Acceptance and Commitment Therapy (ACT; pronounced "act"), Compassion Focused Therapy, and DBT (which I mention elsewhere on this blog). I am a huge fan of Third Wave approaches.
The cognitive Second Wave approaches work on correcting "irrational" beliefs (e.g. I am a worthless person). For instance, we might examine the evidence for and against the argument that you're worthless. As it turns out, once you think about it, maybe you're not really all that worthless.
But the Eastern-influenced Third Wave CBT treatments emphatically do not aim to correct irrational beliefs!
Third Wave approaches mainly focus on noticing thoughts like "I'm worthless" and trying to change one's relationship to the thought, but not the content of the thought itself.
For instance, a Third Wave approach might simply focus on the fact that "I'm worthless" is coming into the mind and that it isn't a particularly useful thought to attend to. The treatment would aim to pull the person out of their head and into contact with the present. So instead of attending to the thought "I am worthless," a person may be encouraged to shift the attention to the breath, for example.
Third Wave approaches offer a lot more than just this, and are very rich approaches, but I think this represents the general idea.
If you're interested in learning more, I highly suggest reading The Compassionate Mind and The Compassionate Mind Approach to Overcoming Anxiety.
For more posts, check out The Psychology Easel and follow me on Twitter at @TaraDeliberto.
So, there have been three "waves" of CBT. The first was behavior therapy, the second was cognitive behavior therapy, and the third is mindfulness/meditation related.
The Third Wave CBT approaches are very tied into Eastern religion. The names of the most well known Third Wave approaches are Acceptance and Commitment Therapy (ACT; pronounced "act"), Compassion Focused Therapy, and DBT (which I mention elsewhere on this blog). I am a huge fan of Third Wave approaches.
The cognitive Second Wave approaches work on correcting "irrational" beliefs (e.g. I am a worthless person). For instance, we might examine the evidence for and against the argument that you're worthless. As it turns out, once you think about it, maybe you're not really all that worthless.
But the Eastern-influenced Third Wave CBT treatments emphatically do not aim to correct irrational beliefs!
Third Wave approaches mainly focus on noticing thoughts like "I'm worthless" and trying to change one's relationship to the thought, but not the content of the thought itself.
For instance, a Third Wave approach might simply focus on the fact that "I'm worthless" is coming into the mind and that it isn't a particularly useful thought to attend to. The treatment would aim to pull the person out of their head and into contact with the present. So instead of attending to the thought "I am worthless," a person may be encouraged to shift the attention to the breath, for example.
Third Wave approaches offer a lot more than just this, and are very rich approaches, but I think this represents the general idea.
If you're interested in learning more, I highly suggest reading The Compassionate Mind and The Compassionate Mind Approach to Overcoming Anxiety.
For more posts, check out The Psychology Easel and follow me on Twitter at @TaraDeliberto.
Monday, January 16, 2012
"Suicide is Selfish"
I often hear people say things like "suicide is the most selfish thing you can do" and "suicidal people must not care about their families at all."
Well, I just don't think that is the case.
First of all, many do not have families who are particularly supportive, which may be part of the problem in the first place. In fact, many times people who attempt suicide are surrounded by people who are extremely abusive. Especially if the person is a teenager or has limited resources, they may see no way out.
And even if people who have attempted suicide do have people in their lives that are supportive, the person may be truly in so much psychological pain - e.g. they may be bombarded with flashbacks of a very traumatic event or paralyzed by depression - that it might be nearly impossible to take into consideration the perspective of a loved one.
On top of this, some people may feel so worthless that they think ending their lives will actually be doing their loved ones a favor. What's even more upsetting is that in some situations, the person's perception may be accurate - it isn't always, but it could be. Stigma against people with mental health is strong and I'm sure some family members might consider a person with mental health issues to be a burden. Of course, this isn't always the case, but it's certainly a possibility.
Please note that whether or not a person's family actually does believe them to be a burden has no bearing on whether or not a person should kill themselves. Clearly this question is out of the depth of this blog post. In this post I am merely illustrating reasons why it is myopic to negatively judge people who have suicidal thoughts. I've heard stories so horrific, it seems incredible that a person could have any will to live at all. It is not a therapist's job to judge whether or not a person should kill themselves. It is our job, however, to do everything possible to teach skills that can make life more bearable.
My advice is simply this: don't be so quick to judge.
Well, I just don't think that is the case.
First of all, many do not have families who are particularly supportive, which may be part of the problem in the first place. In fact, many times people who attempt suicide are surrounded by people who are extremely abusive. Especially if the person is a teenager or has limited resources, they may see no way out.
And even if people who have attempted suicide do have people in their lives that are supportive, the person may be truly in so much psychological pain - e.g. they may be bombarded with flashbacks of a very traumatic event or paralyzed by depression - that it might be nearly impossible to take into consideration the perspective of a loved one.
On top of this, some people may feel so worthless that they think ending their lives will actually be doing their loved ones a favor. What's even more upsetting is that in some situations, the person's perception may be accurate - it isn't always, but it could be. Stigma against people with mental health is strong and I'm sure some family members might consider a person with mental health issues to be a burden. Of course, this isn't always the case, but it's certainly a possibility.
Please note that whether or not a person's family actually does believe them to be a burden has no bearing on whether or not a person should kill themselves. Clearly this question is out of the depth of this blog post. In this post I am merely illustrating reasons why it is myopic to negatively judge people who have suicidal thoughts. I've heard stories so horrific, it seems incredible that a person could have any will to live at all. It is not a therapist's job to judge whether or not a person should kill themselves. It is our job, however, to do everything possible to teach skills that can make life more bearable.
My advice is simply this: don't be so quick to judge.
Sunday, January 15, 2012
Eating Disorder Statistics
Just came across this great resource for eating disorders. Please check out the website for the National Association for Anorexia and Associated Disorders, Inc.
Saturday, January 14, 2012
Near Death Euphoria and the Link to Suicide
I thought this was a really thought-provoking question. The link between near-death euphoria and suicide never crossed my mind before.
This was my response:
I have heard of people recounting similar types of experiences, but I had never considered the link between near-death euphoria and the intention to commit suicide.
A brief discussion of Thomas Joiner's theory of suicide is in order. The basic gist is that people may build a tolerance for the negative feelings associated with hurting / killing themselves by engaging in self-injurious or thrill seeking activities. While it is not necessarily intentional, the negative feelings about death may lessen over time.
Let's just say a person regularly sky dives. Then, for whatever reason, they become suicidal. If you're already used to jumping out of planes, the idea is maybe you won't be that scared to jump off of a bridge.
There is another relevant example to this discussion as well. Namely, if a person regularly cuts themselves (without intent to die) when they're upset, they may not be scared to make life-threatening incisions when suicidal urges come up.
While I formerly thought of this concept as similar to "building up the courage" to attempt suicide via repeated episodes of cutting / dare-devil behavior, this question has me thinking differently. Perhaps there is an additional component here that is consistent with Joiner's theory.
When people cut their skin with no intent to die, it is thought that endorphins are released. This would create reduction in the negative feelings that may prompt self-injury, like shame, anxiety, sadness, etc. Perhaps people also feel mild euphoria, or positive feelings, from the endorphins. This might suggest that for some, self-injury has at least two psychological functions - reducing negative feelings and increasing positive feelings - perhaps produced by the same biological mechanism (i.e. endorphin release).
In any event, a link between injuring oneself and feeling good is formed. Maybe this association generalizes to suicide in the sense that injuring yourself is linked with feeling good.
Now, getting more to the point of suicide, endorphins are not only relesaed during self-injury, but during a traumatic / near-death event as well. This is very interesting to me because a link can be formed between feeling good and death, specifically. In the sky diving example used above, an association is formed between feeling good and jumping from a height, but not necessarily death. In the case of a traumatic event, the link is formed between feeling good and specifically being near-death.
While people may not report chasing the feeling of euphoria that comes with being close to death, if they've experienced it, the drive for this positive feeling could theoretically propel future suicidal behavior. Whether or not the person is aware that they are driven to suicide because of past feelings of euphoria when close to death, it could be a biological function maintaining the behavior.
In short, while I had formerly thought of suicide as a behavior maintained by the function of wanting to escape pain, this point raises the question of whether or not people want to commit suicide to actually feel better. Again, while I don't think people would necessarily report wanting to die to feel that euphoria, it could influence their suicidal drive and behavior.
[For people familiar with psychology lingo on this blog, the function may not necessarily just be automatic negative reinforcement, but automatic positive reinforcement as well.]
Truly, a fascinating point. Thank you so much for asking.
For more posts, check out The Psychology Easel and follow me on Twitter at @TaraDeliberto.
Friday, January 13, 2012
CBT Resources
New Harbinger Publications has a wonderful resource for people with a variety of concerns including, but not limited to, bulimia, anorexia, panic, ADHD, sexual disorders, etc. It discusses each problem and what the most effective treatment for the consumer is. Click here.
I absolutely love this. Easy-to-read consumer resources describing the most effective treatments out there are few and far between. I hope you find this helpful! If you have any questions, please let me know.
I absolutely love this. Easy-to-read consumer resources describing the most effective treatments out there are few and far between. I hope you find this helpful! If you have any questions, please let me know.
Monday, January 9, 2012
The Dissertation Meter
My dissertation is currently at 84 pages. And that is just the introduction!
Really excited about my topic - the psychology of dieting. I can't wait to blog about the results in about a year from now. Only 250 pages of writing left!
Really excited about my topic - the psychology of dieting. I can't wait to blog about the results in about a year from now. Only 250 pages of writing left!
Wednesday, January 4, 2012
Is There Anything to be Learned from Freud's Oedipal Complex?
Ever wonder if what happened between Oedpius and his mother could happen in real life? Well, apparently it can. And there is a name for it: genetic sexual attraction.
Genetic sexual attraction occurs when genetic relatives meet for the first time in adulthood and an attraction develops. Although it is a rare occurrence, there has been an increase in the number of reported cases in recent years, typically as a consequence of adoption (according to Wikipedia).
I'm no fan of Freud, but it kind of makes me think.
It should definitely be noted though, that for the vast majority of people, it is thought that living in close domestic proximity as children become desensitized to later attraction. This hypothesized phenomenon is known as the Westermark effect. It only pertains to children being raised together, and does not take into consideration whether or not they are genetically related.
I'm not so much wondering about whether or not there is unconscious attraction between members of domestically-cohesive family units in the way Freud talked about it, but how the concepts of both genetic sexual attraction and the Westermarck effect can relate to normative relationships.
Sure, there have been documented accounts of attraction in types of incestuous relationships, but this certainly isn't the norm. Nor do I think this is due to under-reporting! And no, I'm not so sure that a lack of awareness of unconscious motivations is the reason either.
I think it might go something like this:
The Westermarck effect occurs for most people, but there might be a genetic reason why it doesn't kick in for some. I'm guessing this might be the case for the people in a documentary I watched - two genetic siblings who were raised together, eventually developed a relationship and started a family. [What was your physiological reaction to that little story? That's your Westermarck effect in action.]
So while there are probably genetic components coming into play when we see a lack of Westermarck effect, I'm guessing there might be some environmental components at work as well. I'll spare you the details of my thoughts about this, though! Suffices to say that there is usually a mix of genetics and environment resulting in any behavior - normative or not. [Basically, I'm guessing certain conditions can prompt this behavior. I also think that a lack of development of the Westermarck effect could be observed in people who are attracted to people in roles similar to that of a parent (e.g. the classic example of women without a father figure dating a much older man).]
Ok, so while the Westermarck effect (and any generalization about attraction to people in parental roles) may be the norm, what about the genetic sexual attraction sometimes seen in some people who are adopted?
Well, despite the popular cliche` that opposites attract, I'm not so sure. I've certainly come across research saying that people tend to pair off who are similar across many different areas. As you've probably experienced, bonding can occur when you have similar thoughts to someone else. Sure it would be boring if you were exactly the same, but I'm guessing you're probably more similar to the people you're close with than different.
Basically, if you're genetically similar to someone that you meet in adulthood, you could actually be very similar to them, being that genetics play such an important role in personality formation. An account from an adopted woman about her eventual relationship with her genetic father, described a close bond forming because she was more similar to him than anyone she had ever met.
In short, I don't think that we all have suppressed genetic sexual attraction - probably due to the Westermarck effect developing (and most of the time generalizing to people in similar roles). I'd imagine that people are simply attracted to people who directly or indirectly validate them because of similar attitudes.
For more posts from The Psychology Easel, visit the homepage.
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As a side note: the problem of marriages or relationships going stale because more of a sibling relationship can develop, may be an interesting generalization of the Westermarck effect. I wonder if some have a stronger inclination for this effect (perhaps couples with a lack of sex drive). It may also have something to do with early development. Different types of effects could theoretically occur (e.g. quick forming attraction and then the Westermarck effect kicking in). Who knows? Something to think about.
Genetic sexual attraction occurs when genetic relatives meet for the first time in adulthood and an attraction develops. Although it is a rare occurrence, there has been an increase in the number of reported cases in recent years, typically as a consequence of adoption (according to Wikipedia).
I'm no fan of Freud, but it kind of makes me think.
It should definitely be noted though, that for the vast majority of people, it is thought that living in close domestic proximity as children become desensitized to later attraction. This hypothesized phenomenon is known as the Westermark effect. It only pertains to children being raised together, and does not take into consideration whether or not they are genetically related.
I'm not so much wondering about whether or not there is unconscious attraction between members of domestically-cohesive family units in the way Freud talked about it, but how the concepts of both genetic sexual attraction and the Westermarck effect can relate to normative relationships.
Sure, there have been documented accounts of attraction in types of incestuous relationships, but this certainly isn't the norm. Nor do I think this is due to under-reporting! And no, I'm not so sure that a lack of awareness of unconscious motivations is the reason either.
I think it might go something like this:
The Westermarck effect occurs for most people, but there might be a genetic reason why it doesn't kick in for some. I'm guessing this might be the case for the people in a documentary I watched - two genetic siblings who were raised together, eventually developed a relationship and started a family. [What was your physiological reaction to that little story? That's your Westermarck effect in action.]
So while there are probably genetic components coming into play when we see a lack of Westermarck effect, I'm guessing there might be some environmental components at work as well. I'll spare you the details of my thoughts about this, though! Suffices to say that there is usually a mix of genetics and environment resulting in any behavior - normative or not. [Basically, I'm guessing certain conditions can prompt this behavior. I also think that a lack of development of the Westermarck effect could be observed in people who are attracted to people in roles similar to that of a parent (e.g. the classic example of women without a father figure dating a much older man).]
Ok, so while the Westermarck effect (and any generalization about attraction to people in parental roles) may be the norm, what about the genetic sexual attraction sometimes seen in some people who are adopted?
Well, despite the popular cliche` that opposites attract, I'm not so sure. I've certainly come across research saying that people tend to pair off who are similar across many different areas. As you've probably experienced, bonding can occur when you have similar thoughts to someone else. Sure it would be boring if you were exactly the same, but I'm guessing you're probably more similar to the people you're close with than different.
Basically, if you're genetically similar to someone that you meet in adulthood, you could actually be very similar to them, being that genetics play such an important role in personality formation. An account from an adopted woman about her eventual relationship with her genetic father, described a close bond forming because she was more similar to him than anyone she had ever met.
In short, I don't think that we all have suppressed genetic sexual attraction - probably due to the Westermarck effect developing (and most of the time generalizing to people in similar roles). I'd imagine that people are simply attracted to people who directly or indirectly validate them because of similar attitudes.
For more posts from The Psychology Easel, visit the homepage.
---------------------------------------------------------------------------------------------
As a side note: the problem of marriages or relationships going stale because more of a sibling relationship can develop, may be an interesting generalization of the Westermarck effect. I wonder if some have a stronger inclination for this effect (perhaps couples with a lack of sex drive). It may also have something to do with early development. Different types of effects could theoretically occur (e.g. quick forming attraction and then the Westermarck effect kicking in). Who knows? Something to think about.
Tuesday, January 3, 2012
Stop Complimenting Me on How I Look
P.S. Here's another observation: extreme discomfort with compliments over time in people with eating disorders. Eventually, it just doesn't feel good to get those addictive compliments any more. Maybe this is a sign of improvement?
I think a recognition that this whole game is dangerous and shallow might precede this phenomenon. At the beginning of a drug addiction, people might think that it is all fun and games. Eventually, they can reach a point of developing an aversion, after all of the consequences come to fruition. I think it is the same for eating disorders.
The drug is achieving incremental goals of deprivation and social approval. In cases I've seen, it appears that the aversion to social approval piece comes first, followed by a disregard for monitoring food intake - but only in people who have truly recovered.
I think a recognition that this whole game is dangerous and shallow might precede this phenomenon. At the beginning of a drug addiction, people might think that it is all fun and games. Eventually, they can reach a point of developing an aversion, after all of the consequences come to fruition. I think it is the same for eating disorders.
The drug is achieving incremental goals of deprivation and social approval. In cases I've seen, it appears that the aversion to social approval piece comes first, followed by a disregard for monitoring food intake - but only in people who have truly recovered.
Eating Disorders - Are They Really about Control?
by Tara Deliberto
The concept that eating disorders are all about control never sat well with me. Specifically, the explanation that people with eating disorders "can't control anything in their lives, so they control food," seems a bit too... poetic. I understand the general idea, but it seems only to hit the target. I prefer the bull's eye.
Rather than simply increasing control, they way I perceive it, eating disorders seems to be more about the asceticism component. For those unfamiliar with this term, asceticism is the practice of depriving oneself of worldly pleasures. As it applies here, asceticism would involve depriving oneself of things that taste good. While it may not sound like fun, there is definitely a rush that comes along with achieving a goal in line with your values.
If your value is looking good by societal standards (i.e being thin), then you'll feel good about taking that self-depriving step towards trying to lose a bit more weight - e.g. passing on dessert. There is definitely some psychological reward from having this Spartan mentality. On top of this, if you value achievement and hard work, it seems you'll certainly at an increased risk of deriving a lot of pleasure from controlling food intake.
Ok, so we have identified two fundamental components so far:
1. valuing looking good by societal standards (i.e. thinness)
2. putting in lots of effort to achieve a goal
So, moving on! If you have these values coupled with an environment that is chaotic and/or not rewarding, I'd imagine you'd be really looking for a way to feel good somehow. Because it might be difficult to feel good with a dearth of positive things in your life, you might start to adapt. Maybe you'll start getting your kicks from deprivation rather than your run-of-the-mill pleasures.
Perhaps you decide you want to start looking good because then you'd be happy. Why not try to lose some weight. Ok, so you limit your food. It sure feels good to be in control and achieve a goal.
Fast forward a few weeks. You lose some weight. People start to notice. "Wow, you look great!" Man, those compliments feel good. [And not only that, maybe all those self-esteem killing negative comments about your appearance disappeared too.]
Wham! Eating disorder.
I'd imagine there is a cycle where psychological reinforcement from depriving oneself and looking good feed off each other. The more you deprive yourself, the more compliments you get etc. Over time, depriving oneself is just linked with feeling good. Especially if that is the primary way you can feel positive, I'd imagine this whole deprivation/compliment reinforcement cycle mess is quite addicting. People look to score small amounts of pleasure by depriving themselves, while chasing the big goal of all those compliments and social approval.
While I'd love to speculate more, I have a research proposal to write tonight!
So, to wrap up: it doesn't seem to suffice to say that eating disorders are about "control." There are certainly other areas to be addressed in treatment, but areas to be targeted rather than simply "control," might be:
1. Valuing what society deems as attractive
2. Valuing extremely perfectionistic work towards achieving goals in line w/ the above value
3. Getting high off of asceticism
4. Getting high off of compliments
5. Potentially not receiving reinforcement and/or deriving pleasure from other areas
In short, this notion that people can't control anything in their environment so they control food, is too poetic for my taste!
Ok, back to writing my research proposal on disordered eating! That's all for today.
For more posts from The Psychology Easel, visit the homepage.
------------------------------------------------------------------------------------------------
P.S. Note to self: Return at a later date to examine which of the components listed above are:
1. necessary-but-not-sufficient
2. necessary-but-can-be-sufficient
3. not-necessary-nor-sufficient-but-can-pop-up.
Quickly, it appears that valuing what society/someone in particular deems attractive is necessary-but-not-sufficient due to the sharp increase in eating disorders as societal ideals changed. Unless, of course, the disorder developed primarily to look unattractive & functions to protect the person from maturity/ sexual abuse. The second component is probably necessary-but-not-sufficient only in anorexia nervosa - where people end up drastically committing to deprivation. With bulimia nervosa / EDNOS, it could exist, but vacillate, or be complicated by a compulsive nature etc.
The concept that eating disorders are all about control never sat well with me. Specifically, the explanation that people with eating disorders "can't control anything in their lives, so they control food," seems a bit too... poetic. I understand the general idea, but it seems only to hit the target. I prefer the bull's eye.
Rather than simply increasing control, they way I perceive it, eating disorders seems to be more about the asceticism component. For those unfamiliar with this term, asceticism is the practice of depriving oneself of worldly pleasures. As it applies here, asceticism would involve depriving oneself of things that taste good. While it may not sound like fun, there is definitely a rush that comes along with achieving a goal in line with your values.
If your value is looking good by societal standards (i.e being thin), then you'll feel good about taking that self-depriving step towards trying to lose a bit more weight - e.g. passing on dessert. There is definitely some psychological reward from having this Spartan mentality. On top of this, if you value achievement and hard work, it seems you'll certainly at an increased risk of deriving a lot of pleasure from controlling food intake.
Ok, so we have identified two fundamental components so far:
1. valuing looking good by societal standards (i.e. thinness)
2. putting in lots of effort to achieve a goal
So, moving on! If you have these values coupled with an environment that is chaotic and/or not rewarding, I'd imagine you'd be really looking for a way to feel good somehow. Because it might be difficult to feel good with a dearth of positive things in your life, you might start to adapt. Maybe you'll start getting your kicks from deprivation rather than your run-of-the-mill pleasures.
Perhaps you decide you want to start looking good because then you'd be happy. Why not try to lose some weight. Ok, so you limit your food. It sure feels good to be in control and achieve a goal.
Fast forward a few weeks. You lose some weight. People start to notice. "Wow, you look great!" Man, those compliments feel good. [And not only that, maybe all those self-esteem killing negative comments about your appearance disappeared too.]
Wham! Eating disorder.
I'd imagine there is a cycle where psychological reinforcement from depriving oneself and looking good feed off each other. The more you deprive yourself, the more compliments you get etc. Over time, depriving oneself is just linked with feeling good. Especially if that is the primary way you can feel positive, I'd imagine this whole deprivation/compliment reinforcement cycle mess is quite addicting. People look to score small amounts of pleasure by depriving themselves, while chasing the big goal of all those compliments and social approval.
While I'd love to speculate more, I have a research proposal to write tonight!
So, to wrap up: it doesn't seem to suffice to say that eating disorders are about "control." There are certainly other areas to be addressed in treatment, but areas to be targeted rather than simply "control," might be:
1. Valuing what society deems as attractive
2. Valuing extremely perfectionistic work towards achieving goals in line w/ the above value
3. Getting high off of asceticism
4. Getting high off of compliments
5. Potentially not receiving reinforcement and/or deriving pleasure from other areas
In short, this notion that people can't control anything in their environment so they control food, is too poetic for my taste!
Ok, back to writing my research proposal on disordered eating! That's all for today.
For more posts from The Psychology Easel, visit the homepage.
------------------------------------------------------------------------------------------------
P.S. Note to self: Return at a later date to examine which of the components listed above are:
1. necessary-but-not-sufficient
2. necessary-but-can-be-sufficient
3. not-necessary-nor-sufficient-but-can-pop-up.
Quickly, it appears that valuing what society/someone in particular deems attractive is necessary-but-not-sufficient due to the sharp increase in eating disorders as societal ideals changed. Unless, of course, the disorder developed primarily to look unattractive & functions to protect the person from maturity/ sexual abuse. The second component is probably necessary-but-not-sufficient only in anorexia nervosa - where people end up drastically committing to deprivation. With bulimia nervosa / EDNOS, it could exist, but vacillate, or be complicated by a compulsive nature etc.
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