Archive for September, 2011
Treatment For Postpartum Depression
When Heidi Koss picks up her daughter Bronwen from middle school in a Seattle suburb, it’s completely routine: They chat about kickball and whether Bronwen ate the muffin her mother packed for a snack.
But 10 years ago when Bronwen was born, things were anything but ordinary, says Koss.
“I felt nothing toward my baby,” says Koss. “One day I woke up and I didn’t care about her.”
Koss was going through postpartum depression, or PPD, thought to be caused by a combination of stress, genetics and hormonal changes. It was her second time; she’d also had it after the birth of her first daughter, Elora. Surveys show that 1 in 7 new mothers in the U.S. have a prolonged period of overwhelming depression or anxiety after giving birth.
PPD is different from the “baby blues,” a term for the temporary sadness that can hit women right after birth for a few days or a few weeks. PPD lasts for months and bears a special stigma that makes it more difficult for mothers to get care, not just in the U.S. but in other parts of the world as well.
Symptoms can include changes in sleep or weight or activity levels, intense anxiety and a lack of interest in life. One study shows that half of women with PPD have obsessions, like thoughts of hurting their babies.
On The Brink Of Suicide
Koss had those violent thoughts, and they drove her to attempt suicide. Her husband pulled her back from a third-floor window ledge. She held a knife to her wrist. And at one point, she lined up a lethal dose of pills.
The only thing that that kept her from suicide was her conviction that no one would love her baby as much as she did, and no one would take care of her as well.
Her profound unhappiness was hard for her to admit at the time. “I felt like admitting that I was struggling meant I was a bad mother, so I kind of put on my best face and best foot forward and soldiered on,” she says.
She eventually went to her obstetrician, but he said there was nothing much he could do. Then Koss found a support group, now known as Postpartum Support International, 17 months after Elora was born. After Bronwen was born, Koss got treatment, and while she still suffered symptoms, she says that with the help of the support group, she didn’t feel so alone.
Katherine Wisner, a professor of psychiatry at the University of Pittsburgh who’s been studying postpartum depression since 1985, says it’s hard to get doctors interested in PPD. She says many are not trained for it, and insurance companies often don’t reimburse for it.
But, she says, treatment, which consists of counseling or antidepressants, can help about half the time, and acknowledging the disease can at least ease the social strain.
Mothers from all socioeconomic groups are affected. In a recent survey of 10,000 women who had given birth at a University of Pittsburgh hospital, Wisner and her colleagues found that 14 percent across all economic classes showed symptoms that met the criteria for PPD.
PPD In Uganda
And PPD occurs outside the U.S., too. Take, for example, Uganda, a country whose government has made access to mental health care a new priority.
In a 1983 paper in the journal Social Psychiatry, Scottish psychiatrist John Cox looked at 18 women in Uganda with PPD. He reported that the women were unlikely to seek medical care for their condition, and that their symptoms were similar to those in Scottish women, except for one thing: The Ugandan women felt less guilty about their PPD.
One reason may be that many were never aware of exactly what they had. Psychiatrist Florence Baingana — one of about 30 psychiatrists in Uganda — says there isn’t much awareness about PPD as a mental illness. “If it isn’t recognized as a mental disorder, the stigma may not be attached to it,” she says. The downside is that many cases are likely to go undiagnosed and untreated. The upside is that women are more willing to be treated.
That’s what happened with 30-year-old Dorothy Mwesiga, who lives in a small village. Mwesiga had symptoms of PPD after all three of her babies were born.
Sometimes she would just sit, unable to do anything other than feel anxious. She says she felt like she was losing her mind and was terrified someone would take her babies away. “After the first time, I was frightened,” she said. “But I thought it would be the end of it.”
Mwesiga got help from a local nurse, Emmanuel Musumba, who like most other health officers across Uganda, has gotten some psychiatric training from the government. He treated her with antidepressant drugs and talk therapy, and she got better. But Mwesiga was never told she had PPD; instead Musumba told her she had “the worries.”
Treating ‘The Worries’
Her husband, a driver for the pastor of the local church, has been enormously supportive, she says, and so have her relatives and neighbors. But Musumba says that wouldn’t be the case if they thought she had a mental illness.
“In Africa,” he says, “depression is not easy to explain. I told her I was treating the worries, and that all would be well if she took the medication.”
Mwesiga’s only worry now is that she will run out of free medication provided by the government before her depression ends. It happens often, he says.
Koss, the American woman with PPD, went on to get a master’s degree and a license as a mental health practitioner. She counsels women about PPD and is active with the support group Postpartum Support International.
She thinks the stigma against PPD in the U.S. is lessening in part because celebrities such as Brooke Shields have gone public about their own PPD. “I now feel comfortable talking about it,” Koss says. “There’s not as much shame.”
http://www.npr.org/2011/08/01/138830120/stigma-hinders-treatment-for-postpartum-depression
Neglected Children Increases Obesity
Strategies for decreasing a child’s risk for obesity often focus on improving eating habits and maintaining a high level of physical activity. While this is one way to address the issue, another way to reduce the risk of childhood obesity could simply come down to positive parenting, according to a Temple University study published in the November issue of Child Abuse & Neglect.
“This is the first study to show the association between neglect in childhood and childhood obesity. Previous studies looked at maltreatment in childhood and how it affected these individuals in adulthood,” said Dr. Robert Whitaker, the study’s lead author and a pediatrician and professor of public health at Temple University.
Examples of neglect include a parent not showing enough affection to the child due to preoccupation with his/her own problems, not taking a child to the doctor when he/she needed it, and leaving a child at home without the proper supervision.
Data was obtained from the Fragile Families and Child Wellbeing Study, a birth cohort study of 4,898 children born between 1998 and 2000 in 20 large U.S. cities. At age 3, 2,412 of these children had their height and weight measured, and mothers answered items on the Parent-Child Conflict Tactics Scales about three types of child maltreatment in the prior year: neglect (such as not providing proper supervision for the child), corporal punishment (such as spanking the child on the bottom with a bare hand) and psychological aggression (such as threatening to spank the child but not actually doing it).
Eighteen percent of the children were obese, and the prevalence of any episode of neglect, corporal punishment or psychological aggression was 11 percent, 84 percent and 93 percent, respectively.
The odds of obesity were 50 percent greater in children who had experienced neglect, after controlling for the income and number of children in the household, the mothers’ race/ethnicity, education, marital status, body mass index, prenatal smoking and age, and the children’s sex and birth weight. Neither the frequency of corporal punishment nor psychological aggression was associated with an increased risk of obesity.
“Corporal punishment and psychological aggression are common discipline techniques resulting from a child’s misbehavior, and the child may come to anticipate them as consequences of their misbehavior,” Whitaker said.
“In contrast, the child may not understand the cause of the neglect and the child might mistakenly feel at fault,” he added.
“These experiences of neglect could translate into a great deal of stress for the child, which might, in turn, influence mood, anxiety, diet and activity. As we know, adults eat in response to stress; the same could be true for children,” Whitaker said.
“You can’t make a child’s life stress free, but parents can strive to be more of a buffer against stress, rather than one of the causes of stress,” he said.
Temple University (2007, November 16). Higher Risk Of Obesity For Children Neglected By Parents
Read Full Post | Make a Comment ( None so far )Spanking Kids Increases Risk Of Sexual Problems
Children who are spanked or victims of other corporal punishment are more likely to have sexual problems as a teen or adult, according to new research presented today by Murray Straus, co-director of the Family Research Laboratory at the University of New Hampshire.
Straus presented his new research findings at the American Psychological Association’s Summit on Violence and Abuse in Relationships: Connecting Agendas and Forging New Directions held Feb. 28 and 29 in Bethesda, MD.
Straus analyzed the results of four studies and found that spanking and other corporal punishment by parents is associated with an increased probability of three sexual problems as a teen or adult:
- Verbally and physically coercing a dating partner to have sex.
- Risky sex such as premarital sex without a condom.
- Masochistic sex such as being aroused by being spanked when having sex.
“These results, together with the results of more than 100 other studies, suggest that spanking is one of the roots of relationship violence and mental health problems. Because there is 93 percent agreement between studies that investigated harmful side effects of spanking, and because over 90 percent of U.S. parents spank toddlers, the potential benefits for prevention of sexual and relationship violence is large,” Straus says.
“Furthermore, because other research shows spanking is not more effective than other discipline methods, there is no need to expose children to the harmful effects of spanking. We can help prevent mental health problems and relationship violence from happening by a national health policy recommending never spanking,” he says.
Coerced Sex
A survey of more than 14,000 university students in 32 nations found that 29 percent of the male and 21 percent of the female students had verbally coerced sex from another person. Coerced sex involves insisting on sex when the partner does not want to, or threatening to end the relationship if the partner does not have sex.
The percentages of those who physically forced sex were much lower: 1.7 percent of the men and 1.2 percent of the women said they had used physical force, such as holding down the partner or hitting a partner to make them have sex.
“The most important finding of this study is that each increase of one step on a four-step measure of corporal punishment was associated with a 10 percent increase in the probability of verbal sexual coercion by men and a 12 percent increase in sexual coercion by women,” Straus says. “The relation of corporal punishment to physically forcing sex was even stronger. Each increase of one step in corporal punishment was associated with a 33 percent increase in the probability of men forcing sex and a 27 percent increase in the probability of women doing this.”
Risky Sex
In the second study, Straus analyzed the same sample of university students, but focused on whether they had insisted on sex without using a condom. Straus found that 15 percent of the men and 13 percent of the women had insisted on sex without a condom at least once in the past year.
Using the four-step corporal punishment scale, Straus found that of the group with the lowest score on the corporal punishment scale, 12.5 percent had insisted on unprotected sex. In contrast, 25 percent of students in the highest corporal punishment group engaged in this type of risky sex.
The third study analyzed data on 440 students in a New Hampshire high school. The students were divided into five groups, ranging from those who were never spanked to those whose parents used corporal punishment even when they were 13 years old and older. The study evaluated eight indicators of risky sex, such as more than one sex partner.
Straus found that students who had experienced corporal punishment had engaged in more risky sexual behavior than students who had not been spanked. From this study, Straus concludes that corporal punishment weakens the bond between the child and the parents. He believes that this alienation from parents may make teenagers less likely to avoid sex and less likely to follow safe sex practices.
Masochistic Sex
In the fourth study, Straus asked 207 students at three colleges about whether they had ever been sexually aroused by masochistic sex: imagining that they were being tied up when having sex, engaging in rough sex, or by spanking, and if they had been sexually aroused by actually doing these three things.
“The core idea of this study is that being spanked by loving parents confuses love with violence, which increases the probability that violence will be part of making love,” Straus says.
The study found that 75 percent of students who had been spanked a lot by their parents were sexually aroused by masochistic sex. In contrast, 40 percent of students who had never been spanked were interested in masochistic sex.
“What is new about this study is a scientific test of the idea that being spanked as a child inclines people to want to be spanked when having sex, and that this is especially likely to be true when there is a combination of lots of spanking and lots of love,” Straus says.
Reducing Spanking
To reduce the use of corporal punishment, Straus recommends that the American Psychological Association, the U.S. Children’s Bureau, and other organizations publicize a recommendation that parents should never spank.
“However, to make this work, we need to start by informing professionals who advise parents about the evidence-base for that policy. They need this information to be able to give appropriate information and help to parents about replacing spanking with positive discipline to correct misbehavior,” he says.
University of New Hampshire (2008, March 2). Spanking Kids Increases Risk Of Sexual Problems As Adults. ScienceDaily. Retrieved July 20, 2011
Read Full Post | Make a Comment ( None so far )Rolemodel your Moms’ Parenting
When it comes to how they raise their children, mothers today tend to follow the same practices their own mothers did, according to a new study that looked at parenting practices across two generations.
Fathers, on the other hand, don’t seem to use their moms as parenting role models, at least for some practices.
Researchers at Ohio State University looked at how often parents in the 1990s spanked, read to and showed affection to their children, and compared that to how these parents were treated by their own mothers.
“We were surprised that mothers seem to learn a lot about the parenting role from their own mothers, but fathers don’t follow their mothers as much,” said Jonathan Vespa, co-author of the study and doctoral student in sociology at Ohio State.
“There was good reason to expect that fathers would have learned parenting from their mothers,” Vespa said.
“These fathers were growing up in 70s and 80s and received much of their parenting from their mothers. Although more women were entering the workforce then, they still did the lion’s share of parenting and childcare.”
Fathers may have been more influenced by their dads rather than their moms, but the surveys used by the study didn’t examine their fathers’ behavior, Vespa said.
“We really need to learn a lot more about how fathers learn to parent,” he said.
The study also revealed significant generational changes in parenting practices, with great increases in the amount of reading and affection shown to children today, and reductions in the amount of spanking.
“While parents, particularly women, are learning many parenting practices from their mothers, there is also a lot of new practices they are picking up from the broader culture,” he said.
Vespa conducted the study with Elizabeth Cooksey, associate professor of sociology at Ohio State, and Canada Keck, a senior research associate at Ohio State’s Center for Human Resource Research.
They presented their research Aug. 9 in San Francisco at the annual meeting. of the American Sociological Association.
One of the strengths of the research is that it looked at actual parenting practices over two generations, following parents and their children over many years, and then continuing to follow the children as they had their own kids, Vespa said.
The data came from the National Longitudinal Survey of Youth, a nationally representative survey of people nationwide conducted by Ohio State’s Center for Human Resource Research. Men and women aged 14 to 22 in 1979 were interviewed annually from 1979 to 1994, and once every two years from 1996 forward. A second survey followed all the children born to mothers in this original survey, from birth through adulthood, as they became parents themselves.
The final sample included 1,133 young adult parents of the mothers from the original NLSY79 survey.
In both generations, the researchers looked at how often parents spanked their children in the past week; how often they showed their child physical affection and praised them in the past week; and how often they read to their child in the past month.
Results showed that for all three behaviors, the second generation of mothers closely followed what their mothers did. For example, mothers who were spanked at least once a week are nearly half as more likely to spank their own children than mothers who weren’t spanked at all.
In most cases, there was no relationship between mothers’ parenting practices and the parenting practices of their sons – the one exception being spanking. And in that instance, fathers who were spanked as children were less likely to spank their own children.
“A little spanking of boys seems to deter them from spanking their own children later in life,” Vespa said.
Overall, there was a large generational shift in which the second generation of parents was much less likely to spank than were their own parents. The reduction was particularly dramatic for fathers – only 28 percent of the second generation of fathers reported spanking their children, compared to 43 percent of mothers.
“The evidence suggests that mothers are more the disciplinarians in the family than fathers are today,” Vespa said.
Another surprising finding was that fathers who spanked their children also tended to show high levels of affection.
“Some fathers might feel that being a strict disciplinarian is part of the way that fathers show affection to their children,” he said.
There was no such connection between affection and spanking for mothers.
In general, the amount of affection parents show their children increased significantly over the generations. Sixty percent of fathers and 73 percent of mothers in the second generation reported showing their children physical affection and praising them within the last week. But only about 40 percent of their parents showed open affection on a weekly basis.
Reading to children also showed a generational shift. Nearly three times more mothers in the second generation reported reading to their children daily compared to their own parents.
Vespa said the results show that some parenting practices are passed down from mother to mother – but only to a point.
“If parents really just learned from their own parents, we wouldn’t witness such dramatic generational shifts as were seen in this study,” he said.
“We need to look at the broader culture to find other sources of change that shape how parents learn to parent.”
Ohio State University (2009, August 12). Mothers, But Not Fathers, Follow Their Own Moms’ Parenting Practices. ScienceDaily. Retrieved July 20, 2011
Read Full Post | Make a Comment ( None so far )getting away is good for your marriage.
For the past decade, Iris Krasnow has spent the month of July apart from her husband of 23 years, Chuck. For most of those summers, she was a counselor at a summer camp in the Adirondacks, where her sons were campers. Since their kids left home, Krasnow and her husband have continued the tradition by taking working vacations on opposite ends of the country, with Krasnow writing in California while her husband launched a rustic furniture company in Maryland. The separation allowed them to bloom as individuals, she explains in her new book The Secret Lives of Wives: Women Share What It Really Takes To Stay Married. And when they reunite, they are “hot to see each other, high on our personal accomplishments, and purged of the inevitable resentments that arise in the grind of the ordinary that long marriage becomes.”
Krasnow interviewed more than 200 women from different educational, social, and economic brackets, all of whom are in long-term marriages like hers (she defines “long term” as 15-plus years) in an effort to figure out what makes unbroken unions work. In addition to relating various pieces of more predictable advice (keep having sex!), many of Krasnow’s subjects shared her experience of prolonged separations, crediting the considerable time they had spent apart from their spouses with making their marriages stronger.
As Krasnow writes, the idea that absence makes the heart grow fonder and all that is a cliché. But it is a cliché for a reason: A review of relevant research confirms that there can be positive aspects to time spent apart from a spouse—at least for wives. (Like Krasnow’s book, many of the sociological and psychological studies on the subject focus on separation’s impact on wives, rather than husbands.) This time apart can take many different forms: The studies don’t just talk about couples who take separate vacations or summer jaunts of the sort Krasnow and her husband have enjoyed. Research has shown that women who are married to fishermen and truckers—careers that can separate spouses for weeks or even months—also profit from time alone.
Time spent apart can benefit women by making them more emotionally self-reliant. As a 1980 study from the Journal of Marriage and Family about dual-career couples who live apart pointed out, “Wives are programmed to think of marriage as an intimacy oasis, an emotionally close relationship that will be ‘total.’ ” Learning that your marriage doesn’t have to be your emotional ballast can be tremendously empowering. One of Krasnow’s subjects, a woman named Tecla, who has been married for 44 years to a Marine Corps officer, backed this up:
Being independent, without a mate, makes day-to-day decisions easier. It eliminates the need to consult, negotiate, and acquiesce to another opinion. … I knew instinctively from early on that my husband was not going to be responsible for my happiness. My happiness depended on me.
Women may also become more physically self-reliant when their husbands are away. A study titled “Family Work and Relationships: Lessons From Families of Men Whose Jobs Require Travel,” published in the journal Family Relations in 2005, reported that while their husbands were away, the wives of fisherman and truckers undertook many traditionally male tasks like yard work and household repairs. Even when their husbands returned from their work trips, the women continued to feel a sense of accomplishment at their new skills. After a five-month separation, one fisherman’s wife said, “I found at the end of the time, I was really proud of myself. … I had to haul water three times and afterward, I felt really good about it, like, I can really do this.”
The communication between spouses can also improve both during and after periods of separation. Some of the wives of truckers and fishermen said that their husbands’ absences meant that when they did see each other or speak by phone, they really talked to each other, unlike peers who saw their husbands every day. One fisherman’s wife said:
Every night he’s gone, he calls and we talk about the day and that’s helped us get a lot closer. In fact, when I hear some of my other friends talking, you know, they’ve got their husbands home every night and during the day and yet they hardly ever discuss anything with each other. They don’t have the conversation.
There is, however, one situation in which separation does not have many benefits: When one member of a military couple is deployed in a war zone. Not surprisingly, a 2010 study from the New England Journal of Medicine showed that the spouses of deployed Army members were more likely to experience depression, anxiety, and sleep disorders than the wives of nondeployed soldiers. As military wife Alison Buckholtz wrote for DoubleX in her “Deployment Diary” series, when every doorbell ringing could bring news of your husband’s death, it’s hard to see any benefit to his absence.
In the prologue to The Secret Lives of Wives, Krasnow says that the most important marital lesson she took from the hundreds of women she spoke to was the importance of maintaining a sense of evolving self, apart from one’s relationship. It’s not that geographic space is the only way of achieving a separate identity—for example, several of the wives said reconnecting with physical pastimes helped them develop their sense of self—but it is a surprisingly effective one. Healthy separation can even inspire the next generation. As Tecla, the military wife, tells Krasnow, she’s glad that she showed her children that it was possible to have adventures even when their father wasn’t around. “Now married with families of their own,” she says, “our daughters have a wonderful sense of independence and never hesitate to go off and have adventures with their own children.”
http://www.slate.com/id/2304336/
Personality and Obesity
People with personality traits of high neuroticism and low conscientiousness are likely to go through cycles of gaining and losing weight throughout their lives, according to an examination of 50 years of data in a study published by the American Psychological Association.
Impulsivity was the strongest predictor of who would be overweight, the researchers found. Study participants who scored in the top 10 percent on impulsivity weighed an average of 22 lbs. more than those in the bottom 10 percent, according to the study.
“Individuals with this constellation of traits tend to give in to temptation and lack the discipline to stay on track amid difficulties or frustration,” the researchers wrote. “To maintain a healthy weight, it is typically necessary to have a healthy diet and a sustained program of physical activity, both of which require commitment and restraint. Such control may be difficult for highly impulsive individuals.”
The researchers, from the National Institute on Aging, looked at data from a longitudinal study of 1,988 people to determine how personality traits are associated with weight and body mass index. Their conclusions were published online in the APA’s Journal of Personality and Social Psychology.
“To the best of our knowledge, we are the first to examine whether personality is associated with fluctuations in weight over time,” they wrote. “Interestingly, our pattern of associations fits nicely with the characteristics of these traits.”
Participants were drawn from the Baltimore Longitudinal Study of Aging, an ongoing multidisciplinary study of normal aging administered by the National Institute on Aging. Subjects were generally healthy and highly educated, with an average of 16.53 years of education. The sample was 71 percent white, 22 percent black, 7 percent other ethnicity; 50 percent were women. All were assessed on what’s known as the “Big Five” personality traits — openness, conscientiousness, extraversion, agreeableness and neuroticism — as well as on 30 subcategories of these personality traits. Subjects were weighed and measured over time. This resulted in a total of 14,531 assessments across the 50 years of the study.
Although weight tends to increase gradually as people age, the researchers, led by Angelina R. Sutin, PhD, found greater weight gain among impulsive people; those who enjoy taking risks; and those who are antagonistic — especially those who are cynical, competitive and aggressive.
“Previous research has found that impulsive individuals are prone to binge eating and alcohol consumption,” Sutin said. “These behavioral patterns may contribute to weight gain over time.”
Among their other findings: Conscientious participants tended to be leaner and weight did not contribute to changes in personality across adulthood.
“The pathway from personality traits to weight gain is complex and probably includes physiological mechanisms, in addition to behavioral ones,” Sutin said. “We hope that by more clearly identifying the association between personality and obesity, more tailored treatments will be developed. For example, lifestyle and exercise interventions that are done in a group setting may be more effective for extroverts than for introverts.”
Angelina R. Sutin, Luigi Ferrucci, Alan B. Zonderman, Antonio Terracciano. Personality and obesity across the adult life span.. Journal of Personality and Social Psychology, 2011;
Read Full Post | Make a Comment ( None so far )Beliefs Behind Anger
Some people think that you will unravel your beliefs by writing down the thoughts in your head. If you do that you will be missing many of the underlying beliefs below those thoughts. There’s a more effective way. To give you an idea of what is involved in a core belief inventory I’ve charted out an example below.
If you are hoping to change an emotional reaction it can be difficult. Either it is too big to stop, and you get carried away, or you don’t even know where to start. In the example I break down an emotional reaction into smaller and smaller pieces. In this thin slicing approach you are able to see that an emotional reaction of anger is actually formed and sustained by several different beliefs, and several different points of view. One of the easy ways to change an emotional reaction like anger is to break it down into smaller manageable pieces.
Below is an exampe inventory from one of my clients that helped build his awareness of all the contributing elements and change his emotonal reactions.
Example: Feeling Angry and Frustrated With Your Boss
Feeling frustrated and angry at work is way too common. A common source of frustration and anger is our relationship with our boss. I’ll share with you about Mike who felt frustrated and even angry at the lack of recognition for his efforts at work. What is important about this story is what Mike’s beliefs were in connection with the story. The beliefs in Mike’s mind have as much or more to do with his frustration as his boss. But we usually don’t look at those beliefs. We are usually too busy noticing what our boss is doing or not doing to catch what the mind is up to. In Mikes case he was unaware of the beliefs behind is thoughts. When he took the time to take an inventory of his beliefs he saw a way of eliminating the frustration he was having with his boss.
Mike’s original understanding of what caused his frustration
Mike doesn’t feel valued by his boss. She (the boss) doesn’t appreciate what he has to contribute. At times she doesn’t even want to hear his ideas. He feels frustrated and even gets angry at his boss for closing the door on what he is passionate about.
If Mike doesn’t want to feel frustrated and angry any more what can he do?
Some people might advise that he attempt to open the lines of communication with her. Others might tell Mike to let it go, don’t make such a big deal about it, or get another job if it really bothers him.
He has tried to have a discussion with his boss about the issue but she shrugs it off. She doesn’t feel it is a problem and wants Mike to get on with his work. She is not as interested in Mike’s ideas as with getting the job done the way she wants it done.
Opening up lines of communication with someone in order to clear the air is a good idea. But if you aren’t aware of different aspects of your own personality then you may be headed into the conversation blind. To see the rest of the picture Mike might be better served by understanding how his belief system affects his emotions.
When Mike shared this situation he was aware that he had a role in the emotional dynamic, but didn’t know what part was his responsibility. He also didn’t know what was getting his emotions stirred up. There were various aspects of his personality that were at play that he hadn’t identified. I refer to these aspects as archetype characters. Using archetype characters becomes a helpful way to break out the subtle differences between emotions like anger and frustration.
Understanding the Whole Picture of what the Mind is Doing
Mike shared the other stories that were going on in his mind. They weave beliefs together to form a string of emotional reactions that I outline below.
- She (the boss) is not open to new ideas.
- The organization would be better off if she were more open and implement some of his ideas.
- She wants to maintain control
- She should recognize my value and what I have to contribute.
It didn’t take long for Mike to look at these comments and figure out it was his inner judge running with these stories.
Some other thoughts and feelings Mike had in his mind
- Mike also noticed he felt sad just before he felt angry about the lack of recognition.
- Mike felt that he could do her job better than her.
- Mike had become aware that his anger was pushing up ideas of defiance and rebellion. He wanted to sabotage the boss’s efforts and prove she was doing things wrong. These weren’t thoughts he wanted to have.
Fortunately Mike had enough awareness to observe the different attitudes and emotions in this dynamic and so this only took a few minutes. With that we laid out the matrix of beliefs that were at the core of his emotional reactions. It looked like this.
| Archetype Character | Storyline and / or Behavior | Emotion |
| Princess | Ideal of how Mike should be treated by his boss. This included recognition to the degree that his ideas had to be implemented. | Pride, self worth, but also self importance and ego |
| Victim | Boss wasn’t recognizing Mike according to hidden criteria of expectations. Mike believed he was being mistreated relative to this criteria. | Hurt, sad, feeling of unworthiness |
| Victim | My personal value is based on my contributions. This paradigm isn’t spoken but is hidden in the reaction. | Disempowering |
| Victim | Mike held his boss responsible for his hurt and sadness (blame). This victim interpretation gave him a feeling that she had power over his emotions. | Powerlessness |
| Authentic Desire | I want to change this feeling. | Emotional Integrity |
| Victim (distorts the authentic desire) | “I want to change this situation and emotion but I can’t.” Having given power over his emotion to his boss creates the paradigm that he can’t change his own emotions. | Frustration, and feeling trapped |
| Judge | The feeling of powerlessness added to his story that she was controlling. | Sense of being right about her. |
| Judge | She hurt him and therefore should be punished. | Righteous |
| Judge | The boss shouldn’t be so controlling and instead should be more open to ideas. | Feeling of being right (self importance) |
| Judge | She is a poor boss and is not doing a good job. | Righteous |
| This series of judgments is a reaction to the disempowering beliefs of the victim character. It is a way compensate by building himself up and feeling better emotionally. The image of himself on the moral high ground is closer to authenticity but falsely based. It only supports the rationalizations for his anger. | ||
| Judge | “Because I am right and she is wrong I have the moral high ground here. Punishment is now authorized.” | Righteous and moral |
| Rebel | “I’m going to punish her by directing my anger at her.” | Anger |
| Rebel | “I’m going to sabotage her projects to prove I’m right. This retribution will be justice.” | Sense of defiance and justice about it |
Sometimes people give up the fight to be heard and get their ideas across. They let go of their passion, but keep the sense of powerlessness from the victim’s archetype. This is a set up to feed stories of judgment and anger later. They don’t feel frustrated, but they aren’t happy and fulfilled either.
When you inventory and change the specific problem beliefs you can let go of what upsets you while continuing to be inspired and engaged by the aspects of work you enjoy. In Mike’s case he can shift the expectations of his boss without throwing in the towel about other aspects of his job.
Trying to solve the problem without Self Awareness
Consider the scenario of Mike not being aware of how his belief system was interpreting his boss’s behavior. Consider that he is not aware of how the archetypes of his personality are affecting his attitude and emotions. If Mike were to seek an open communication dialogue with his boss how would it go? He would likely and unknowingly bring attitudes of judgment, victimization, princess expectations, and rebellion to the conversation. Mike would probably feel “right” according to his belief system and archetypes, but that wouldn’t make for a healthy constructive dialogue.
Looking inward and taking responsibility for our half of the emotional reaction is an uncommon approach. However it is also the empowering one. If we look outwards and point the finger at someone else we are claiming to be powerless over what is happening inside ourselves. Being aware that our happiness and emotions are a product of our beliefs puts the capacity for change in our own hands.
If you take careful notice of the chain reaction of stories and emotions you will see that the first reaction was to his boss. From then on Mike was basically reacting to his the interpretations in his mind and the emotions he felt. The belief system and voices in his head was reacting to itself.
As self awareness grows you gain more dominion over the core beliefs in your mind and the characters of your personality. Awareness and responsibility allow you to dispense with unpleasant emotional reactions by choosing how you interpret events and what you will believe. Dominion over your beliefs allows you to create happiness for yourself in all your relationships.
Read Full Post | Make a Comment ( None so far )Anger Management Treatment Guide
Many different strategies and skills for anger management intervention have been tried and tested. Some of the most empirically supported interventions are cognitive-behavioral interventions including relaxation coping skills, cognitive interventions, behavioral coping and social skills training, and problem-solving skills training.
According to Dahlen and Deffenbacher (2001), relaxation coping skills target both the emotional and physiological arousal associated with anger with the intent being to lower the anger arousal. In contrast to targeting arousal, cognitive interventions target biases in information processing and cognitive appraisals. They help to identify distorted patterns of thinking, develop more reality-based and less anger-engendering cognitions, and free up problem-solving and coping resources.
Behavioral coping and social skills training target the actual expression of anger (vs. reducing anger arousal). Specific skills training that has been empirically supported includes direct coping skills (e.g., interpersonal communication, negotiation, feedback), related coping skills (e.g., parenting, budgeting and financial planning, assertive communication), and inductive social skills training (e.g., clients identify and explore effective behaviors for coping with anger) (Dahlen and Deffenbacher, 2001).
Problem-solving skills training is useful when there are no behavioral skill deficits (e.g., poor social skills) but there is a lack of general problem-solving skills with which to assess situations and to choose various coping skills. A basic problem-solving methodology is to identify the problem, generate alternative solutions, consider theconsequences of each solution, select an effective and appropriate response, and evaluate the outcomes of implementing the specific response (Skiba & McKelvey, 2000).
Additional strategies that have been found to be useful in managing anger effectively include avoiding situations that make one angry, changing environments, focusing on something positive, engaging in substitute positive activities, and improving communication and social skills. Humor has also been found to be helpful when it is used constructively to help face problems; sarcastic humor is just another form of unhealthy anger expression (Controlling anger before it controls you, n.d.).
Structured Programs
In addition to the strategies and skills highlighted above, there are numerous structured and pre-packaged programs for helping people learn to manage their anger more effectively. These programs vary in intended audience, theoretical basis, teaching method, and actual skills and techniques used.
Cultural Impact of Client’s Natural Environment
Howells and Day (2002) highlight the importance of understanding the culture a client returns to upon leaving a counseling or training session. Will the culture support the behavior changes and thinking processes that the client has been learning? In some cases (e.g., the gang a client hangs out with, incarcerated clients, institutionalized clients), the culture the client lives in day-to-day will not necessarily support the kinds of changes a client may be trying to make.
Indeed, daily survival may be based on vastly different modes of operation than a client may be practicing in counseling. It is important to clarify which culture is in charge of the client’s daily life (e.g., the family and its subcultures? the street corner and friends? the neighborhood? the school and teachers?) and how it may affect a client’s success in learning to manage anger more effectively.
Transferring Skills to the Classroom/Workplace/Home
Another consideration is the adequate transfer of skills learned in counseling to one’s natural environment. This could be the classroom, the workplace, or even one’s home. Besley (1999) conducted an experiment on transferring skills to the classroom environment of a student client.
According to Besley (1999), change begins at a teachable moment, and four conditions are necessary for change:
the person is in an environment where he or she feels safe,
the person is supported and encouraged during the change process,
the environment is relevant to the person, and
the person is involved and has some degree of control in the change process.
In a school setting, when a counselor has been working with a student individually to develop more effective anger management skills, there still remains the issue of encouraging the student to use the new skills outside the counseling sessions (e.g., in the classroom, in the cafeteria, on the playground). One proven way to do this is to have the counselor sit in the classroom (or cafeteria or playground) with the student and be available to coach the student right at the moment(s) he or she becomes angry (Besley, 1999). The counselor can then coach the student’s cognitive processes and help the student cope with impulsivity and, at the same time, model effective and useful skills for the other students and even the teacher.
Readiness for Anger Management Intervention
The best anger management training delivered by the most qualified counselor will be ineffective if the client is not ready for anger management training. According to Howells & Day (2003), there are several different things that can impact readiness for anger management.
Sometimes there are a complex array of factors presenting with the anger problem. People with certain mental and personality disorders may also have an anger management problem. Or anger management and control may be a symptom of a serious mental or personality disorder.
Existing client inferences about their anger “problem” can impact their readiness. Some clients may view anger as an appropriate response to many situations. Some clients may believe that catharsis is the best approach (expressing anger is considered better than controlling it) or that angry responses get results (in reality, although angry outbursts sometimes generate desired short- term results, they rarely result in long-term change). Attitudes of self-righteousness, low personal responsibility, blaming others, and condemning others also reduce readiness. For some clients, anger may not even be considered a problem. In fact, anger may be adaptive in certain settings for the client: it may bring with it many social benefits such as perceptions of higher status, strength, and competence. Unfortunately, these types of beliefs and perceptions can be difficult to uncover and assess.
The client’s skill level also impacts readiness for effective treatment. People need certain cognitive processes with which to think about consequences and choices in order to improve anger management skills. Sometimes a person’s impulsive nature will interfere with the application of such cognitive processes. Other issues that impact a client’s readiness are difficulty judging the intent of others, underestimating one’s own reaction to anger-provoking situations, wanting to blame conflict on others, an inability to distinguish one’s feelings, and poor social and problem-solving skills.
Finally, the client’s beliefs about treatment impact readiness. Even in coerced or mandatory treatment, if the client concurs with the need for treatment and perceives the treatment as likely to be helpful in meeting his or her goals, then coercion is not as big an issue. However, if the client believes the treatment is not likely to fulfill his or her personal goals, then coercion could definitely impact readiness.
How does a counselor positively influence the readiness variables? Counselors can explore the personal goals of the client and help the client become aware of any discrepancies between the actual social consequences of their anger expression and the pursuit of their personal goals. Counselors can work to incorporate the client’s goals and treatment plan into the values and goals of the existing informal culture of the client.
Counselors can also help clients build appropriate interpersonal and cognitive skills and develop an appropriate vocabulary for communicating triggers, thoughts, emotions, and behaviors.
Variables that Influence Effective Treatment
In studies on the effect of anger management interventions with student populations, Skiba and McKelvey (2000) found three variables to have the most influence. First, the length of treatment: typically, more sessions yield stronger initial outcomes and booster sessions (e.g., annually) improve long-term outcomes. Second, proper framing: the more the training is made relevant to the student and the environments in which he or she lives on a daily basis, the stronger the initial outcomes. Finally, supplemental interventions (e.g., utilizing weekly goals, utilizing components of Aggression Replacement Training) help improve initial outcomes. Although these factors were studied specifically in reference to student populations, they are likely applicable to other client bases as well.
Besley, K. R. (1999). Anger management: Immediate intervention by counselor coach. Professional School Counseling, 3(2), pp. 81-90.
Controlling anger before it controls you (n.d.). Retrieved July 23, 2003 from National Mental Health Association Web site: http://www.nmha.org/infocrt/factsheets/44.cfm
Dahlen, E. R. & Deffenbacher, J. L. (2001). Anger management. In W. J. Lyddon. & J. V. Jones, Jr. (Eds.), Empirically supported cognitive therapies: Current and future applications (pp. 163-181). New York: Springer Publishing Company.
Howells, K. & Day, A. (2003). Readiness for anger management: clinical and theoretical issues. Clinical Psychology Review, 23. pp. 319-337.
Skiba, R. & McKelvey, J. (2000). What works in preventing school violence: The safe and responsive fact sheet series – Anger management. Retrieved July 23, 2003 from http://www.indiana.edu/~safeschl/AngerManagement.pdf
Read Full Post | Make a Comment ( None so far )Anger Management Research
Anger. Everybody experiences it and everybody expresses it. It is a natural and healthyhuman emotion when managed effectively. But it can be a source of various physical, mental, emotional, social, or legal problems when not managed effectively. It is often a problem in one of these areas that brings a client in for counseling, either on a voluntary or a mandated basis. As a counselor, there are numerous and varied options for intervention. And there are numerous and varied aspects to consider before selecting an appropriate intervention.
DEFINING ANGER
There are many different views from which to consider the construct of anger. Dahlen and Deffenbacher (2001) identify three main ingredients to anger. First, there is an anger-eliciting stimulus, typically an easily-identifiable external source (e.g., somebody did something to me) or internal source (e.g., emotional wounds). Second, there is a pre-anger state, which includes one’s cognitive, emotional, and physical state at the time of provocation; one’s enduring psychological characteristics; and one’s cultural messages about anger and about expressing anger. Third, there is one’s appraisal of the anger-eliciting stimulus and one’s ability to cope with the stimulus. All three of these ingredients interact to create a state of being angry.
Dahlen and Deffenbacher (2001) also identify four related domains in which anger exists. First, in the emotional and experiential domain, anger is a feeling state ranging in intensity from mild annoyance to rage and fury. Second, in the physiological domain, anger is associated with adrenal release, increased muscle tension, and activation of the sympathetic nervous system.
Third, in the cognitive domain, anger is associated with biased information processing. Fourth, in the behavior domain, anger can be either functional (e.g., being assertive, setting limits) or dysfunctional (e.g., being aggressive, withdrawing, using alcohol and drugs, etc.).
Rhoades (n.d.) provides additional ways to understand anger. What is the source and expression of the anger? Is it intense and situation-specific or chronic and generalized? What is the extent of the anger? Does it easily and quickly evolve into deep feelings of resentment? Is it coupled with intense aggression or explosiveness? Has it become uncontrollable? What is the anger hiding? Is it a cover-up for fear, being used as a shield to keep other people at a distance so they are unable to see one’s insecurities and weaknesses?
EXPRESSING ANGER
The expression of anger can take many forms. Some common means of expressing anger include venting, resisting, seeking revenge, expressing dislike, avoiding the source of anger, and seeking help (Marion, 1997). However, in many cultures, people are taught that while expressing anxiety, depression or other emotions is acceptable, expressing anger is not (Controlling anger before it controls you, n.d.). As a result, many people never learn how to handle their own or others’ anger effectively or to channel it constructively.
Gorkin (2000) distinguishes between the intention and the usefulness of anger expressions. In terms of intention, the expression of anger can be purposeful or spontaneous. The purposeful expression of anger is intentional, has a significant degree of consideration or calculation, and yields a high degree of self-control. The spontaneous expression of anger is immediate, has little premeditation, and yields little to moderate self-control.
In terms of usefulness, the expression of anger can be constructive or destructive. Constructive expression of anger affirms and acknowledges one’s integrity and boundaries without intention to threaten another person. Destructive expression of anger defensively projects and rigidly fortifies one’s vulnerable identity and boundaries. These distinctions provide for four basic expressions of anger. Purposeful and constructive expression leads to assertion. Purposeful and destructive expression leads to hostility. Spontaneous and constructive expression leads to passion and suffering. And spontaneous and destructive expression leads to rage, violence, screaming, and hitting. With respect to rage, one can be outraged, by a seemingly clear and external (sometimes criminal) target, or one can be “in-raged” (Gorkin, 2000), by a reaction to still unresolved internal hurts and humiliations (vs. actual, immediate stimulus-and-response provocation).
Although much of the work in anger management focuses on helping people understand what triggers their anger and on learning a healthier response, or expression, of that anger, the debate continues regarding the healthiest ways to express anger. Interestingly, some sources (e.g., Schwartz, 1990) indicate that repressing anger can be adaptive for coping with certain emotions. Other sources (e.g., Controlling anger before it controls you, n.d.) document that suppressing anger can lead to headaches, hypertension, high blood pressure, depression, emotional disturbances, gastrointestinal disorders, respiratory disorders, skin disorders, genitourinary disorders, arthritis, disabilities of the nervous system, circulatory disorders, and even suicide. It is important to learn to identify whether or not a client’s reactions to and expressions of anger are a problem.
ASSESSING ANGER
How does a client know when his or her anger is more of a problem than a help? Few formal assessments exist to quantifiably measure the level of one’s anger. However, there are numerous qualitative indicators to review with clients to understand the extent of their concerns about their anger and anger management strategies.
Is the anger chronic, long-lasting, too intense, or too frequent (Rhoades, n.d.)?
Does the anger disrupt the client’s thinking, affect the client’s relationships (Rhoades, n.d.), or affect the client’s school or work performance?
Does the client exhibit frequent loss of temper at slight provocations, passive-aggressive behavior, a cynical or hostile personality, chronic irritability and grumpiness?
Has the client begun to display low self-esteem, sulking, or brooding?
Is the client withdrawing socially from family and friends?
Is the client getting physically sick or doing damage to one’s own or others’ bodies or property?
Is the client experiencing physical symptoms such as increased heart rate, increased blood pressure, or increased adrenaline flow (Controlling anger before it controls you, n.d.)?
Although some of these symptoms may be indicative of other issues, they are also often related to unresolved anger. The bottom line is that when a person becomes a victim to his or her anger, the anger is a problem.
MANAGING ANGER
According to Wellness Reproductions (1991), there are three main methods of dealing with anger. First, there is “stuffing” one’s anger, a process in which a person may or may not admit his or her anger to self or others and in which one avoids direct confrontations. A person may stuff his or her anger out of fear of hurting someone, fear of rejection, fear of damaging relationships or fear of losing control. Often, a person who stuffs anger is unable to cope with strong, intense emotions and thinks that anger is inappropriate or unacceptable. Stuffing one’s anger typically results in impaired relationships and compromised physical and mental health.
Second, there is escalating one’s anger, a process in which a person provokes blame and shame. The purpose is to demonstrate power and strength while avoiding the expression of underlying emotions. A person who escalates his or her anger is often afraid of getting close to other people and lacks effective communication skills. Escalating one’s anger typically yields short-term results, impaired relationships, and compromised physical and mental health. Sometimes, escalating one’s anger also leads to physical destruction of property or to abusive situations, thus adding the potential for legal ramifications.
Third, there is managing one’s anger, a process in which a person is open, honest, and direct and in which one mobilizes oneself in a positive direction. The focus is on the specific behavior that triggered the anger and on the present (past issues are not brought into the current issue). A person who manages his or her anger avoids black and white thinking (e.g., never, always, etc.), uses effective communication skills to share feelings and needs, checks for possible compromises, and assesses what is at stake by choosing to stay angry versus dealing with the anger. Managing one’s anger results in an increased energy level, effective communication skills, strengthened relationships, improved physical and mental health, and boosted self-esteem.
SUMMARY
It is this process of managing one’s anger that is the primary goal of counseling people to effectively deal with anger. The goal is not to eliminate anger. Anger is a natural and healthy emotion. After a client acknowledges he or she is angry, a counselor can help the client learn how to reduce the emotional and physiological arousal that anger causes and learn to control its effects on people and the environment. To be more effective, practitioners should attempt to understand the extent and expression of the anger, the specific problems resulting from the anger, the function the anger serves, the underlying source of the anger, and the domain the problems occur in (e.g. emotional, physiological, or cognitive) before choosing interventions for the client.
REFERENCES
Controlling anger before it controls you (n.d.). Retrieved July 23, 2003 from National Mental Health Association Web site: http://www.nmha.org/infoctr/factsheets/44.cfm
Dahlen, E. R. & Deffenbacher, J. L. (2001). Anger management. In W. J. Lyddon. & J.
V. Jones, Jr. (Eds.), Empirically supported cognitive therapies: Current and future applications (pp. 163-181). New York: Springer Publishing Company.
Gorkin, M. (2000, August 17). The four faces of anger. Retrieved July 23, 2003 from http://www.selfhelpmagazine.com/articles/growth/facesofanger.html
Marion, M. (1997). Guiding young children’s understanding and management of anger. Young Children, 52(7), p. 62-67.
Rhoades, G. F. (n.d.) Anger management online conference transcript. Retrieved July 23, 2003 from http://www.healthyplace.com/Communities/Abuse/Site/transcripts/angermanagement.htm
Schwartz, G. E. (1990). Psychobiology of repression and health: A systems approach. In J. L. Singer (Ed.), Repression and dissociation: Implications for personality theory, psychopathology, and health. Chicago: University of Chicago Press.
Sleepy People seek Revenge
Results show that sleepiness was positively correlated with counterfactual think¬ing, which involves thoughts about how events in the past could have been different. Sleepier people were more likely to imagine how outcomes could have been better than reality and think about how the behavior of others could have produced better outcomes. In contrast, sleepier people were not more likely to imagine how their own behavior could have produced better outcomes. Sleepiness also was positively correlated with all three subscales of displaced aggression: angry rumination, behavioral displaced aggression and revenge planning.
According to the authors, research has shown that sleepiness negatively impacts mood and impairs the integration of emotion and cognitions when making moral judgments. However, no prior studies had investigated how sleepiness affects social cognitions such as counterfac¬tual thinking and displaced aggression.
“The sleepier people are, in this case college students, the more likely they are to engage in thinking about what might have been, called ‘counterfactual thinking,’ and to engage in more thoughts about displaced aggression,” said principal investigator David Mastin, PhD, associate professor of psychology at the University of Arkansas at Little Rock.
Mastin noted that previous research has suggested that counterfactual thinkers might be more motivated and analytical. However, the current study suggests that sleepiness heightens the negative side of counterfactual thinking.
“Sleepier people seem to engage in counterfactual thinking that is more dissatisfied and perhaps more selfish,” said Mastin. “It may be that the sleepier you are, the more likely your musings are to be angry thoughts about how others could have done better.”
Mastin, along with co-authors Julie Steel, PhD, and Brittany Berry from UALR, and Jennifer Peszka, PhD, from Hendrix College, gathered data from 108 college students with a mean age of 24 years; 75 percent were women. Participants provided sociodemographic data and completed self-report questionnaires including the Epworth Sleepiness Scale, the Counterfactual Thinking for Negative Events Scale, and the Displaced Aggression Questionnaire.
According to Mastin, the findings have practical implications for interpersonal relationships, such as in workplace interactions and performance evaluations. The study also makes an important contribution to the understanding of social decision making.
“It may be that sleepiness-related changes in social cognition will lead to a greater understanding of emotional intelligence and suggest methods of coping,” Mastin said.
American Academy of Sleep Medicine (2011, July 7).
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