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Can Counseling Help With Depression?

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Depression is a serious mood disorder, with an estimated 16 million American adults having at least one major depressive episode in the past year.1 It can affect how you think, feel, interact with people, and handle daily life. It can cause feelings of sadness and a loss of interest or pleasure in things you once enjoyed. Anyone can be affected by depression, and it can happen at any age, but it often begins in adulthood.

The good news is, depression is highly treatable, with reports of 80% to 90% of people responding well to treatment.2 One of the reasons depression responds so well to treatment is the success of the therapeutic process. Finding the right counselor, psychotherapist, or psychologist that can help you understand and work through the underlying causes of depression as well as develop coping strategies to deal with the symptoms is the first step to feeling better.

Types of Depression

What makes depression a bit more complicated to understand is that anyone can feel this way. Diagnosing depression requires a complex process involving a psychiatrist, psychologist, or other mental health professional. In general, to be diagnosed with depression, symptoms need to be present for at least two weeks.

There are several types of depression as defined by the DSM-5 including, but not limited to, major depressive disorder, persistent depressive disorder, seasonal affective disorder (major depressive disorder with a seasonal pattern), postpartum depression (depression with peripartum onset), and bipolar disorder.

Treating Depression

Depression is often treated with medications called antidepressants, therapy, or a combination of the two. There are several types of antidepressant medications available. It may take some time to find the right one for you, so working closely with your doctor is critical during this time. Once you find one that works, you may notice an improvement in how you feel within a month.

Treating depression with therapy or psychotherapy has proven helpful in both short-term and long-term cases of depression.3 Like medications, there are various forms of therapy and experts to choose from. Some of the more common evidence-based approaches include cognitive-behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy.

Counseling vs. Psychotherapy

Treating depression with “talk therapy” is often the first step with mild to moderate depression. Many experts will go this route prior to trying medication. If depression is more severe, a combination of therapy and medication may happen at the same time. Before moving forward, it’s important to understand the differences between counseling and psychotherapy.

While the two are very similar, it’s important to note that sometimes, psychotherapy with a licensed psychologist or psychiatrist (MD) is considered more of a long-term approach that focuses on severe depression and issues that are significantly impacting your life. Counseling, on the other hand, is seen more as a short-term therapy (up to 6 months) that may focus more on mild to moderate depression, especially if it is a newer issue.

Counseling for Depression

The length and severity of the symptoms and episodes of depression often determine the type of therapy. If you’ve been depressed for a length of time and the symptoms are severe, working with a psychiatrist or psychologist (PsyD) may be necessary since they deal more with issues from the past that may be deeply-rooted in your present feelings. But if the symptoms of depression are more recent or not as severe, working with a therapist in a counseling relationship may be the way to go.

During counseling, the therapist will use “talk therapy” to help you understand and work through the issues that are impacting your life in negative ways. Their role is to listen, provide feedback, and work with you to develop strategies to cope. They will also evaluate your progress and adjust the sessions accordingly. You may be asked to do homework that extends the learning from the counseling sessions. Often, this is in the form of tracking moods and feelings.

Counseling for depression focuses more on present thoughts, feelings, and behaviors and how these things are affecting your life currently. That’s why CBT has been a useful model to use in counseling sessions.

With CBT, the therapist can help you change negative thinking that may be making the symptoms of depression worse. The focus is goal-oriented, with you, the patient, taking an active role.

Since CBT is generally considered short-term therapy, it’s often a top choice for therapists when working with mild to moderate cases of depression that may not need long-term, in-depth psychotherapy. Evidence suggests that CBT works well in counseling for depression.4 It’s also proven to reduce relapse or recurrence rates of depression once counseling has ceased.

Interpersonal therapy (IPT) is another brief or short-term method used in counseling for depression that focuses on interpersonal conflict and poor social support, which can lead to feelings of depression. IPT can help you communicate better and address issues that make the symptoms of depression worse. Evidence suggests that IPT is effective in acute treatment of depression, and it may help prevent new depressive disorders.

How to Find a Counselor

Finding the right counselor, psychologist, or mental health expert to work with may take some time. When it comes to counseling for depression, the relationship between patient and counselor is key to the success of the therapy. It’s important to be patient and open to the process. You may find that you need to see a few people before finding someone you trust.

If you’re not sure where to look, a good place to start is with your doctor. You can also contact any larger mental health facilities in your area. While they may not offer the services you need, they will likely know of counselors close to where you live that provide therapy for depression.

Finally, spend some time researching the experts in your area. Go online and read their bios. Send an email asking for more information about their preferred forms of treatment and how they interact with clients. Many therapists offer a free intro session to see if it is a good fit. Find out if they offer a free trial session and give it a try.

One other form of counseling to consider, especially for more mild forms of depression, is online therapy. The popularity of online therapy has increased in the last few years as more people are seeking help but often feel more comfortable doing it Online resources and apps such as Talkspace offer support via a desktop or mobile app with a variety of services including individual sessions, comprehensive courses taught by a therapist that help you work through issues related to depression and come up with and practice coping strategies.

Living with depression can feel overwhelming at times. Working with a mental health expert in a therapeutic relationship provides you with a safe environment to identify the thoughts, feelings, and patterns of behavior that are contributing to your symptoms. Counseling can also help you learn new coping skills and techniques to better manage the symptoms.

Short-term counseling, which typically lasts 6 months or less, is appropriate for mild to moderate depression. If you feel like you could benefit from counseling for depression, talk with your doctor about getting a referral. Finding someone you trust and feel comfortable opening up to is critical in the success of the counseling process.

By Sara Lindberg

How to Meet Loss and Pain Without Fear

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By practicing compassion we can open the heart to the universality of the human condition with clarity, allowing us to respond to difficulty with balance and care.

Mindfulness involves several attitudes of mind that are pivotal to the transformation and liberation of the mind: befriending, compassion, joy and equanimity. These qualities are seen as the foundations of all our development as we embark on a path of mindfulness practice.

Every one of us can cultivate, train, and naturalize these four qualities, in the same way that attention can be trained and developed. In the face of great distress, though, befriending, compassion, joy, and equanimity can disappear just when they are most needed. Today, we’re going to focus on the second of these qualities: compassion.

What Does It Mean to Grow Our Compassion?

Like all capacities, our capacity for compassion grows when we tend to it and nourish it. We have all experienced moments of compassion when the heart softens in the face of pain, distress, and suffering, and when we can be open to the vulnerability that is part of the human experience. These moments can be close to home—such as when a child in our family is sick, or an elderly relative becomes increasingly frail—or on the world stage, such as when we hear about a devastating natural disaster or an innocent bystander grievously injured in an act of senseless violence. In these moments, the divide between self and other softens, the narratives of criticism and blame fade, and we inhabit, perhaps for a few fleeting moments, a world infused with kindness and compassion.

Compassion is an orientation of mind that recognizes pain and the universality of pain in human experience and the capacity to meet that pain with kindness, empathy, equanimity and patience. Its roots in Latin (compati) are to suffer with. Its affective tone is deep care, connection, and responsiveness. It is not, however, an emotion—rather, compassion is an understanding imbued with intention. The near enemy of compassion is pity, because self and other are separated and there is a sense of “I am looking down on your suffering.” Compassion’s far enemy is the wish to see someone harmed, or outright cruelty.

Compassion is central to all of the great foundational spiritual traditions, including Christianity, Buddhism, Hinduism, Judaism, and Islam. Although it takes different forms, the intention to transcend self-centered concerns and the invitation to respond compassionately to pain and suffering is present in each. What is also present in each tradition is the notion that compassion can be trained and cultivated—that sustained and dedicated practice can educate and re-educate the heart. So, although compassion is deep in our natures—present in us even as infants—education, cultivation, training, and practice can help us bring greater intentionality and a wider ethical framework to our compassionate response.

What Does a Compassionate Response Look Like?

As we learn to cultivate compassion in each moment and throughout our lives, we can also learn to differentiate the parts of a compassionate response. Compassion starts with recognizing and acknowledging pain and distress— with this quality of a trembling heart or empathic resonance—and being willing to see and turn toward the difficulty with stillness, wholeheartedness, and receptivity. But crucially embedded in this recognition of pain and distress is a willingness to engage with our bodily sensations, feelings, thoughts, and life circumstances with steadiness, kindness, and care: “I don’t have to endure this pain for the rest of my life, nor let it rule me. I only need to meet it in this moment as a guest, and treat it, as best I can, with kindness and care.”

Mindfulness teaches us to be still and curious in the midst of adversity, to allow for its presence, to explore its landscape, and to befriend it.

So often we have demonized pain and sorrow to the extent that avoidance, flight, or fixing are felt to be our only options. These conditioned responses are, however, a major obstacle to invoking compassion. Worse than that, they maintain our suffering. Mindfulness teaches us to be still and curious in the midst of adversity, to allow for its presence, to explore its landscape, and to befriend it. This is befriending in action, but here the action is to invoke compassion in the face of pain and suffering. This requires patience, resolve, and courage. Initially, this might feel counterintuitive and wrong, since our patterns of avoidance or fixing the difficult are so familiar and understandable to us. In taking this first step, though, we stop allowing suffering to define our lives and who we believe ourselves to be. We learn instead to allow, meet, and even embrace vulnerability rather than fear it. Our recognition of pain and distress is now imbued with this empathic resonance: “Ah, here is pain; it’s OK. I can be alongside this with kindness and care.” It becomes clear that our willingness to be fully present in the midst of pain creates new opportunities for a compassionate response.

How Mindfulness Nurtures an Empathic Resonance

Mindfulness teaches us to calm the tendency to blame, shame, and judge others or ourselves for the pain or suffering in our life. Blame and judgment do little to alleviate distress, but compound it and disable our capacity to understand it. Blame and judgment generate endless narrative and rumination that cloud us from seeing alternative ways to ease our pain and distress.

As we cultivate mindfulness and turn toward the present moment just as it is, we come to understand that although there is not always a solution to suffering, there is always a possible response. Understanding that not all pain can be fixed is not a prescription for passivity. Instead, it is an encouragement for us to find a response that can care for even the direst pain. Finding the willingness to stop running from pain is the first step toward a compassionate response. Not all pain and affliction can be fixed, but all pain and affliction is eased when held with tenderness and compassion.

Understanding that not all pain can be fixed is not a prescription for passivity. Instead, it is an encouragement for us to find a response that can care for even the direst pain.

Developing a stance of care and empathy helps us understand suffering, its causes, and its end, even when the end is found in the midst of the continuing difficulty. This understanding does not in any way diminish or dismiss our present-moment experience, yet we come to understand that we are not alone, but part of a human family that has vulnerability at its core. As compassion is cultivated, we gain dignity and widen our concern to include the suffering of others—the suffering that is present in a wider common humanity. The matrix and phases of compassion loosen the sense of me and mine, you and yours; we glimpse a world where suffering and joy are seen as part of the human condition, to be recognized, met, and allowed. This creates the conditions for a more compassionate responsiveness. Without this understanding, compassion can falter because we limit it to the conditions and people we think are deserving—it becomes ideological and constrained.

This sort of conditional compassion inevitably backfires, fueling fear and alienation. Divisions are created when we think “This pain is OK, this is not, this person is deserving of compassion, this person is not.” Understanding and compassion arise together and mindfulness practices teach us how to care. Consider suffering where there is no blame, a sick child, those caught up in a natural disaster such as a tsunami, the elderly whose health is failing. Then consider the suffering brought on by perpetrators, the refugees escaping ethnic conflict, people who were victimized who go on to victimize others. These examples illustrate the mind’s natural tendency to create a narrative that includes blame, perpetrator, and victim. When understanding and compassion arise together, though, we can respond with our hearts and minds. This protects us from habitual reactivity and enables us to respond with balance and care. It ensures that our responses are imbued with intentionality.

How to Meet the Losses, Unwelcome Changes, and Pain Without fear

Persistence is a key facet of empathy and compassion. Students of mindfulness learn to return their attention over and over to what is happening, just now, in the body and mind. Developing our capacity for sustained mindfulness in the midst of all things (e.g., pain, fear, or the desire to flee) reveals our growing ability for steadiness and resilience. We become more confident that we can meet distress with compassion. Persistence is not about gritting our teeth and stoically enduring pain. It is about caring and understanding how to meet the losses, unwelcome changes, and pain without fear.

We are affected deeply by the sorrows in our own lives and in the world that seem to have no end. One might ask the question: “What do we do with a heartache, a loss, an illness, a life that will bring afflictions that seem to have no end or solution?” Attending to this life and moment with compassion and care provides us with the key to freedom and balance. In committing our attention to the present, just as it is rather than being lost in the narrative of how it should be, we begin to develop resilience and courage, cornerstones in the development of compassion.

With mindfulness we learn that when we transform the present, we can create a new relationship with our past.

In mindfulness programs, this healing transformation is understood in a specific way. Transformation does not mean that distress and suffering disappear. There is little encouragement to delve into the past to dissect the conditions that have resulted in present-moment distress. Those conditions and events cannot be undone. Instead, with mindfulness we learn that when we transform the present, we can create a new relationship with our past. The transformation of the present is a process of changing our relationship to the narratives and somatic imprints of the past as they arise in the present, freeing us from the layers of anxiety, judgment, and narrative that compound distress. Compassion is central to that changed relationship.

Like all capacities, our capacity for compassion grows when we tend to it and nourish it. We are never short of opportunities to engage with this cultivation and need not wait for the dramatic moments of pain or distress. We can learn to mindfully listen to the small murmurs of distress in our bodies with tenderness and care. As we learn to recognize the thoughts and emotions of shame, anxiety, and blame—with tenderness rather than with judgment—we become more attuned to our inner life and the present moment. Our eyes increasingly begin to open to the world around us and we are touched by the vulnerability visible in so many of our encounters in a single day. We may open ourselves up to noticing, for example, the cries of a child, the cautious and faltering walk of an elderly person, the sight of someone begging on the street. In our noticing, we open ourselves to compassion and begin to sense, within ourselves, a heart that can tremble in the face of distress. Rather than turning away in fear or judgment, we start to find the courage and balance to embrace these moments with empathy and compassion.

Try This Mindfulness Exercise to Practice Nourishing Compassion:

1. Taking your seat and turning your attention to your present‐moment experience, bring your attention initially to the places in your body that feel well and easeful. Perhaps attend to the palms of your hand or the sensation of your feet touching the ground.

2. Attune your attention to a body of stillness, a body of restfulness, consciously softening any areas of tension.

3. Sense what it is to cultivate a curious, caring attentiveness.

4. Then extend your attention to parts of the body that feel unpleasant or tight, with the same quality of mindfulness. With the same sense of befriending, alternate your attention between the experience of wellness and any part of the body that feels stressed.

5. Sense what it is to listen deeply to distress with empathy and compassion.

6. When you feel able, extend your field of attention to include those you care for and the many people you meet each day who all have their own measure of joy and sorrow. Perhaps invite into your attention an image of a person struggling with uninvited life pain—loss, frailty, illness.

7. Sense what it is to hold that person within an empathic resonance. You might experiment with a few simple phrases: “Allowing.” “Peace.” “Ease.” “Caring.

BY WILLEM KUYKEN

How to Rebuild Trust in Your Marriage

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Trust in an intimate relationship is rooted in feeling safe with another person. Infidelity, lies, or broken promises can severely damage the trust between a husband and wife. That, however, does not necessarily mean that a marriage can’t be salvaged. Although rebuilding trust can be challenging when there is a significant breach, it is, in fact, possible if both partners are committed to the process.

Picking Up the Pieces

It takes much time and effort to re-establish the sense of safety you need for a marriage to thrive and continue to grow. Recovery from the trauma caused by a break in trust is where many couples who want to get back on track can get stuck.

Research has shown that couples must address the following five sticking points in order to effectively move past a breach of trust:

Knowing the details
Releasing the anger
Showing commitment
Rebuilding trust
Rebuilding the relationship

Whether you were the offending partner or the betrayed, to rebuild the trust in your marriage, both of you must renew your commitment to your marriage and to one another.

Know the Details

Even in seemingly clear-cut cases of betrayal, there are always two sides. The offending partner should be upfront and honest with information, in addition to giving clear answers to any and all questions from their partner. This will give the betrayed party a broader understanding of the situation. What happened, when, and where? What feelings or problems may have contributed to this situation? What were the mitigating circumstances?

Release the Anger

Even minor breaches of trust can lead to mental, emotional, and physical health problems. Partners may have trouble sleeping or diminished appetite. They may become irritable over small things or be quick to trigger.

While it may be tempting to stuff all of the anger and emotions down, it is imperative that betrayed partners tune in and reflect on all the feelings that they have. Consider the impact of your partner’s betrayal on you and others. Reflect on how life has been disrupted and all the questions and doubts that are now emerging. Make your partner aware of all these feelings.

Even the offending partner is encouraged to express any feelings of resentment and anger they may have been harboring since before the incident.

Show Commitment
Both parties, especially the betrayed, may be questioning their commitment to the relationship and wondering if the relationship is still right for them or even salvageable.

Acts of empathy—sharing pain, frustration, and anger; showing remorse and regret; and allowing space for the acknowledgement and validation of hurt feelings—can be healing to both parties.

Building off of this, defining what both sides require from the relationship can help give partners the understanding that proceeding the relationship comes with clear expectations that each person, in moving ahead, has agreed to fulfilling.

Both parties must work to define what is required to stay committed to making the relationship work. In communicating this, avoid using words that can trigger conflict (e.g., always, must, never, should) in describing what you see, expect, or want from your spouse. Instead, choose words that facilitate open conversation and use non-blaming “I” statements.

For example, favor “I need to feel like a priority in your life” over “You never put me first.

Rebuilding Trust

Together, you must set specific goals and realistic timelines for getting your marriage back on track. Recognize that rebuilding trust takes time and requires the following:

*Decide to forgive or to be forgiven. Make a conscious decision to love by trying to let go of the past. While achieving this goal fully may take some time, committing to it is what’s key.

*Be open to self-growth and improvement. You can’t repair broken trust with just promises and statements of forgiveness. The underlying causes for the betrayal need to be identified, examined, and worked on by both spouses for the issues to stay dormant.

*Be aware of your innermost feelings and share your thoughts. Leaving one side to obsess about the situation or action that broke the trust is not going to solve anything. Instead, it is important to openly discuss the details and express all feelings of anger and hurt.

Want it to work. There is no place in the process for lip service or more lies. Be honest about and true to your wishes.

For the Offender

As the person who compromised the relationship, it may be hard or even painful to be reminded of your wrongdoings. Remember, though, that the above steps are essential to the process of repair and recovery. As you work on them:

If you are the one in your marriage who lied, cheated, or broke the trust, your partner needs you to show that the errant behavior is gone by changing your behavior. That means no more secrets, lies, infidelity, or anything else of the sort. Be completely transparent, open, and forthcoming from now on.

Be honest. Work to understand and state why the bad behavior occurred. Statements such as “I don’t know” don’t instill confidence or help you get to the root of the issue.

Take responsibility for your own actions and decisions; defensiveness will only perpetuate the conflict or crisis. Justifying your behavior based on what your spouse is doing or has done in the past is also not productive.

For the Betrayed

While moving forward hinges a lot on what your partner is able to show you, remember that work that you do also has a lot to do with your potential success. As you proceed, day by day:

Actively work on understanding why and what went awry in the relationship before the betrayal actually took place. While this won’t help you forget what happen, it may help you get some answers you need to move on.

As hard as it may be, once you have committed to forgiving your partner, work on providing positive responses and reinforcement to help give your partner consistent feedback to things that please you or make you happy.

Know that it’s also OK if you do not want to continue the relationship after considering the above steps or beginning them. Just be honest with yourself, and your partner and don’t go through the motions just because you feel that is what is expected of you as a devoted partner.

Rebuilding the Relationship
Once couples have committed to rebuilding trust, they must work on treating the relationship like it is a completely new one. Both sides must ask for what they really need and not expect their partner to simply know what it is they want.

Do not withhold trust in this new relationship, even though it is with the same person. Withholding trust out of fear or anger will prevent you from emotionally reconnecting with your partner. This keeps your relationship from moving forward in a healthy way.

Instead, work toward rebuilding the relationship by doing the work required in building trust and rebuilding a mutually supportive connection. Come to an agreement about what a healthy relationship looks like to you both. Some examples include establishing date nights, working on a five year, ten-year and even 20-year plan together, finding your love languages, and checking in with your partner about how you feel the relationship is doing or if it is living up to your expectations.

Remember that all relationships require work. Even the closest of couples have to work hard at renewing the spark while working to grow in the same direction together, year after year.

By Sheri Stritof, Medically reviewed by Steven Gans, MD

Why Are So Many People Struggling With Loneliness?

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Social media apps seemingly bring us closer together, but today’s tech is also leading to unprecedented levels of loneliness.

Nearly everyone feels lonely at some point in their life. Whether it’s the result of being away from friends and family or if it occurs at the end of a relationship, loneliness is a seemingly inevitable aspect of the human experience.

And while it’s OK to feel alone from time to time, recent research reveals that loneliness can be lethal. Pair this news with reports that people in the US are experiencing more loneliness than ever before, and it’s clear that America’s isolation epidemic could lead to a lot of lost lives.

Can Feeling Lonely Really Be Fatal?

It can be hard to believe that loneliness leads to death, yet that’s exactly what a recent report by the American Psychological Association found. Here’s how it happens: Persistent loneliness causes stress, which increases the body’s production of a protein called fibrinogen. An excessive amount of fibrinogen can clog arteries, increase blood pressure, and make people more susceptible to heart attacks. In fact, loneliness has been proven to have as much of an impact on mortality as smoking 15 cigarettes a day, making it even more deadly than obesity. Millennials: The Loneliest Generation Millennials are especially at risk of experiencing social isolation according to recent data from YouGov, which found that members of Generation Y have far fewer relationships than their forebears: 30% of respondents said they didn’t have a best friend; 27% said they had few close friends; 22% said they had no friends at all, and an astonishing 25% said they didn’t even have any acquaintances.

Millennials: The Loneliest Generation

Millennials are especially at risk of experiencing social isolation according to recent data from YouGov, which found that members of Generation Y have far fewer relationships than their forebears: 30% of respondents said they didn’t have a best friend; 27% said they had few close friends; 22% said they had no friends at all, and an astonishing 25% said they didn’t even have any acquaintances. Why Are We So Lonely? So what’s at the source of all this solitude? A recent study points the finger at social media. For all of the ways Facebook, Instagram, and other apps help humanity, that same technology is also undermining our ability to lead fulfilling lives. Yet, ironically, some people are attempting to assuage their isolation by further embracing digital devices.

Modern Ways to Avoid Isolation

Traditionally, people have found it possible to feel less alone by reading, exercising, or engaging in creative activities. Many members of modern society, however, are looking toward more tech-centric solutions. Take, for instance, RentAFriend, an online platform that allows isolated individuals to pay locals for platonic companionship. Then there’s Carenote, a service that connects elderly Americans with friendly Filipinos who (for a modest monthly fee) will regularly call and text solitary seniors. And in Asia, elderly members of Japanese society are buying social robots as a means to cope with their loneliness. But are robotic roommates actually effective enough to stave off solitude?

Can Robots Cure Loneliness?

In Alone Together: Why We Expect More from Technology and Less from Each Other, author Sherry Turkle highlights society’s unhealthy relationship with social media and explains how such platforms can disconnect individuals instead of uniting them. As far as robots are concerned, Turkle details how bonding with today’s increasingly lifelike machines may alleviate feelings of loneliness, but certain people may eventually begin to prefer mechanical companions to their own friends and family members. After all, maintaining a relationship with a machine requires far less effort compared to the needs of their human counterparts, and modern robots never get upset, seek revenge, or grow bored with their owners.

As robots become more advanced, they’re increasingly likely to replace our relationships rather than enhance them. Turkle explains how this may lead some individuals to become so emotionally attached to their computerized companions that they could feel heartbroken when their machine inevitably breaks down.

Similar to social media, social robots ostensibly enrich our lives yet, in reality, they have the potential to increase feelings of isolation. Therefore, Turkle suggests that members of modern society back away from today’s technology, and instead reconnect with others on a more human level. And she’s far from the only author to suggest that lonely people could benefit from a digital detox.

Reducing Dependence on Today’s Technology

In Digital Minimalism: Choosing a Focused Life in a Noisy World, author Cal Newport explains how increased exposure to social media leads to higher levels of loneliness. To undo the ill effects of today’s tech, he outlines several methods readers can use to regain their focus and feel better about themselves by disconnecting from digital devices.

Newport notes that thousands of years of evolution have primed us to maintain intricate social lives — not to text, tweet, and tap thumbs-up icons while staring at a screen. He further explains how hashtags and emojis aren’t equivalent to meaningful human interactions and such forms of communication shouldn’t be considered alternatives to face-to-face conversations. In order to feel less alone, Newport advocates deleting social media apps, scheduling certain times to send text messages, and opting for in-person interactions as often as possible.

How to Make Friends Without Social Media

A December 2018 study published in the Journal of Social & Clinical Psychology found that reducing time spent on social media decreases loneliness and depression. But in a world where billions of people are constantly connected to online platforms, it’s can be easy to fall victim to FOMO even after mere minutes away from a smartphone. Yet despite the dominance of social media, there are still ways to learn how to meet new people that don’t involve scrolling or swiping on a screen.

In Time and How to Spend It: The 7 Rules for Richer, Happier Days, author James Wallman explains how today’s multitude of media platforms are vying for our attention, and he draws on scientific research to help people make better decisions about how to occupy their free time. This includes a checklist readers can use to make new friends while spending time in beneficial ways.

Few people enjoy feeling isolated, Wallman notes, but by embracing activities that foster connections with others, it’s possible to avoid the potentially fatal effects of loneliness. He explains how the key to making new friends is finding fresh ways to connect with other people, which generally involves engaging in interesting activities and going on exciting adventures. This could include signing up for a recreational sports league or joining a group that loves to play board games. No matter what your interests are, there are almost certainly some like-minded individuals eager to accept you into their circle.

Begin by thinking about what activities you like to do, and then conduct some research to discover whether there’s a local group you can join. If you like to go cycling, for instance, there’s bound to be a biking group in your area. If, on the other hand, you prefer to read, find a nearby book club or create one of your own. You could also get more involved with your community to help plan local events or otherwise create a positive difference. And don’t forget that nonsocial experiences such as meditating, writing, and painting, can also reduce feelings of isolation.

Learn More About Avoiding Loneliness

If you’re feeling lonely, social media might be the reason why. The good news is that it’s possible to avoid the ill effects of today’s technology by following the recommendations of today’s leading authors.

by Michael Benninger

How to Use Online Dating Apps Safely

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Over the past several years, the popularity of online dating has skyrocketed compared to where it originally started. In fact, dating apps and websites have given single people a convenient new way to connect with people.

But, with this ease of use comes some new issues, particularly in the form of safety. For instance, interacting with strangers online can put you at risk for identity theft, online harassment, stalking, digital dating abuse, catfishing, and other scams. And, if you do decide to meet up “in real life” (IRL) with someone you met online, there also is the chance that you could find yourself in physical danger as well.

To make navigating the online dating scene a little easier and safer, we have compiled a list of important facts about online dating. We also have put together some tips for selecting the best app for you as well as included keys to staying safe in the online dating world.

Cold, Hard Facts About Online Dating

Whether you are new to online dating, or you consider yourself a pro, it helps to have a clear understanding of what dating apps offer including how often they are used, how they are viewed by others, and even how honest people are when building their profiles. Here is everything you need to know about the online dating industry.

Online dating is growing in popularity

According to the eHarmony website, an online dating program for Christian singles, more than 40 million Americans are using online dating websites.

40% of Americans use online dating as a way to meet new people. What’s more, 27% of young adults report using online dating sites, which is a 10% increase from 2013.

Researchers speculate that this increase is due to the fact that dating apps are now available on smartphones. Meanwhile, online dating among 55 to 64-year-olds has also risen substantially with 12% indicating they use online dating sites compared to only 6% in 2013.

Online dating has lost some of its stigmas

In 2005, when the Pew Research Center first studied online dating habits, most Americans felt it was a subpar way of meeting people. But in their most recent study, nearly half of the public either knows someone who uses online dating or has met a spouse or partner through online dating. Still, 23% of Americans still think “people who use online dating sites are desperate.”

People lie when using online dating sites

To some, it probably comes as no surprise that people lie when creating their online dating profiles. But a whopping 53% of Americans tell little white lies when developing their online profiles according to a survey conducted by the global research firm, Opinion Matters. Overall, women tend to post younger photos of themselves while claiming to be thinner. Meanwhile, men tend to embellish the truth when it comes to their careers attempting to appear more successful than they really are.

Some online daters assume you just want to hook up

Research suggests that many men who use online dating apps assume that women are looking for sex. But studies have shown that is not the case. For instance, the majority of Tinder’s female users are looking for a genuine match and not a fling, even though the app has earned the reputation as being “the hook up” app. In fact, 60% of Tinder’s female users are looking for a relationship and do not want to hook up, according to informal research conducted by the Huffington Post. What’s more, Statistic Brain reports that only 33% of women using online dating websites say they have sex on their first date with an online match.

Statistically, Online Relationships Don’t Last

According to research conducted by Michigan State University, relationships that begin online are nearly 30% more likely to break down than relationships that began through a mutual friend or where couples met face-to-face first. And for couples who met online and then got married, the chances of that relationship working out are even gloomier, with online couples three times as likely to get divorced.

Online Dating Can Be De-Humanizing

The Association of Psychological Science says many people treat online dating like shopping. They swipe through photos looking for the perfect mate often dismissing someone more quickly than they would have had they first met the person face-to-face. Consequently, the researchers warn that online dating can make you picky and judgmental.

Some People Really Are Finding Love Online

According to Statistic Brain’s Online Dating Industry Report, 20% of committed relationships began online. What’s more, they say that 17% of couples that were married in the last year met on a dating website. Meanwhile, Pew Research Center reports that two-thirds of online daters have gone out with someone they were matched with. But, they also found that one-third of people who have used online dating have never actually gone on a date. So, the odds of meeting someone online are improving.

Choosing the Best App for You

When it comes to selecting the best online dating app for you, reading reviews and comparing apps can get confusing, especially when the features and options not only vary widely but are constantly changing and evolving as developers change and improve the apps. And with more than 7,500 dating apps worldwide, there definitely are a lot to choose from. But, it doesn’t have to be overwhelming. Follow these few simple steps to help you find the best app for you.

Review the Safety Features

Online dating can be a risky endeavor because there are so many unknowns. Consequently, you want to be sure that the app you select has some built-in safety features. Ideally, the app will promote its safety guidelines on the sign-up page. But if they do not, or if the safety guidelines are particularly hard to find, you may want to find a different app.

Check Out the Reporting and Blocking Features

Let’s face it, when it comes to online dating, you are going to meet a few weirdos along the way – people that either creep you out or are just downright toxic. When this happens, you want to be able to report their behavior as well as block them from contacting you. For this reason, it is important to know upfront about how the app provides these features. And, if for some reason, there are no reporting or blocking features, then move on to the next app.

Determine the Level of Visibility the App Provides

When reviewing an app, check to see if you are able to control the visibility of your profile. Ideally, you want an app that allows more options to secure your profile. The less you have, the more exposed your information is on the Internet. For instance, the app, Hinge, offers several options for users to control who they see and who sees them. Just remember, the more options an app provides in this area, the better.

Avoid Sites and Apps That Allow Messaging Prior to Matching

No one likes receiving unwanted photos or creepy messages, which certainly is a possibility within dating apps. As a result, it is best to select an app that requires both people to have an interest before messaging can take place. This way, you can reduce the number of unwanted messages you get and limit it to only the people you want to be communicating with.

Pay Attention to the Geography Settings

Many online dating apps use your location as a way of allowing you to find possible matches. However, make sure the app allows you to some control over this setting. It is never a good idea to have an app that allows complete strangers to pinpoint where you are or even find your specific neighborhood. Sharing that kind of information just sets you up for problems.

Look for Free Trials and Free Versions

Most dating apps have both a free version and a paid version. As a result, you shouldn’t shell out for the paid membership before you even know if you like the app or if it will be useful. What’s more, having the free version is not going to keep you from meeting new people.

When you are first starting out, it can be a lot more beneficial to try several different apps to see what works rather than purchasing the premium membership before you have even taken it for a test drive. Plus, dating apps can get expensive if you are paying $10 to $25 a month for the service.

Reconsider Apps That Link to Social Media

Most dating apps like Tinder, Bumble, and Hinge allow people to share data from their social media profiles. This is mostly harmless, but be aware of how much information is revealed on your dating profile as a result.

Remember, you do not know the people on the dating app and giving them access to your social media profile like photos of your family could be risky, especially if you are a single parent.

You also want to keep where you went to school, where you hang out, and even your employer private. Making this information available means that even after you have blocked people through the app, they still could still find you and harass you through social media.

Staying Safe While Using Dating Apps

While you are never to blame if someone behaves in a predatory or disrespectful way toward you in the online dating world, there are things you can do to stay safe. Here are some useful safety tips you can put into practice right away to help you be more mindful.

Use a Unique Photo

When developing your dating profile, avoid using the same photo that you have on your social media accounts. If you use the same photo as your Facebook photo or your Instagram page, it is really easy for someone to do a reverse image search with Google. As a result, if you are using the same photo on all your accounts, it is much easier for someone to find you on social media.

Leave Out the Personal Details

When developing your online dating profile, make sure you do not include your last name, contact information, nicknames, or social media handles. You want to keep the personal details to a minimum. After all, if you come across someone who is a little on the creepy side, you don’t want them having too much information about you.

You may even want to tighten the security on your social media accounts to add another layer of protection. For instance, on Facebook change your page to where everything is private and only able to be viewed by “Friends,” not “Friends of Friends.”

Stay Inside the App

When you are messaging with a potential date, or even after a few dates, it is best to message one another inside the app. Although this might be inconvenient, if something doesn’t work out, you do not have to worry about the fact that the person has your cell number.

What’s more, staying inside the app provides you with an extra layer of protection. Some messaging systems with dating apps do not allow people to send photos or links, which can really reduce the number of unwanted photos you get.

Set Up a Google Phone Number

Eventually, you will want to talk with someone on the phone, either after you have met or beforehand. But instead of giving out your cell number, consider getting a Google phone number and forwarding it to your phone. It is pretty easy to set up. Once you log in to Google Voice, you simply choose your area code and select an available number. The instructions on the rest of the set-up process are pretty simple to follow.

Take Precautions When Meeting IRL

Avoid letting someone know exactly where you live. Instead, arrange to meet in a public place and provide your own transportation. You also should let a close friend know where you will be and when you will be home. You want your friends to know as much information as possible should something go wrong.

Once on your date, be sure you stay aware and alert. Do not leave your drink unattended and keep the first few dates short. You may even want to bring a self-defense tool with you such as pepper spray or a high-powered flashlight. And, if the person you are meeting is making you uncomfortable or scared, enlist the help of a friend in leaving the situation. Remember, you should never feel bad about putting your safety first. Even if you have to do something rude to escape a situation, you need to make sure you are safe.

By Sherri Gordon

How to Make Friends as an Adult

Therapist
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Remember how easy it was to make friends in elementary school? Most of the time your best friends ended up being the kids in your class or in your neighborhood. Or maybe you were best friends with kids whose parents were friends with yours.

As a child, making friends wasn’t as complicated as it feels today. Not only were you less worried about being rejected; you also weren’t as picky about who you were hanging out with. But things have changed now that you are a grown-up. Aside from the fear of rejection, making new friends takes a lot of time—something we all are a little short on these days. So instead, you lament the fact that your circle of friends is shrinking. And, you are not alone.

Research shows that after the age of 25, most adult friendships start to dwindle. Some of this has to do with changing jobs, getting married, moving to another state, and even having children.

But having solid friendships as an adult is important. For instance, one study found that regardless of your marital status, people who reported having 10 or more friends at age 45 had significantly higher levels of well-being at age 50 than those with fewer friends.

What’s more, another study found that friendship quality often predicts health more so than the quality of any other relationship.

In fact, people with larger social circles had a 50% lower mortality risk than those who didn’t. As a result, if your social circles have started to dwindle, here’s what you can do to start adding more friends to your inner circle.

Have the Right Mindset

When it comes to making friends as an adult, you have to have the right mindset. For instance, you cannot go into the process thinking that you are never going to make friends. Because your perception will become your reality. Instead, follow these tips and you will be well on your way to making some lasting friendships.

Focus on Being Open

In other words, don’t overthink the process of making friends. Instead of worrying about being rejected, or dwelling on the fact that you might not be fun enough, channel your inner elementary school self. Likewise, don’t assume that all your future friends have to be the same gender as you. Platonic male-female relationships are absolutely possible. Be open and inviting and see what happens.

Make a List of Potential Friends

Almost every person has one or two people in their life that they would like to get to know better. As a result, make a list of people you might like to hang out with sometime. Remember, making friends takes work and someone needs to take the initiative. After you have your list, consider extending an invitation for coffee and see what happens.

Put It On the Calendar

Let’s face it, everyone is busy. And despite your best intentions, if you don’t schedule it, you likely won’t do anything about making more friends. As a result, decide when you are going to ask that friend from the office to join you for appetizers after work. Set aside time to call the woman from your book club that you really connect with. The key is to schedule these initial contacts because if you don’t, you will just keep putting it off.

Accept Invites

Yes, you are tired, busy, and over-scheduled. But, if someone invites you to do something, try to make it happen! If you have social anxiety, do your best to remember that this person invited you to a get together because they like you and want to get to know you better. Of course, if you cannot afford something or you are sick, then definitely decline the invite. But, make an effort to do something else together instead. Accepting invitations, even if you don’t know the person very well, is a great opportunity to open doors and expand your friendship opportunities.

Try New Things

When you are looking to make friends, it’s important to expand your horizons and try new things. You never know, you might just enjoy these new adventures. Plus, it will open up the possibility of making friends in new and interesting places. Take an art class or a dance class, you might not be the only one stepping out of their comfort zone and that in and of itself can be something to bond over.

Know Where to Find Potential Friends

Part of the challenge of making new friends is knowing where to look. Too many times, people assume that there are just no potential friends out there. But the problem is not the lack of opportunities for friendships, but the inability to put forth the effort to find them.

Reach out to Neighbors

Some of the best friends people have are their neighbors. Yet, many people don’t recognize the potential friend who lives right next door. They simply give the courtesy wave across the street and then close their door. But there may be some really great friendships waiting to be made just down the street from where you live. So, the next time you are both out, do more than just wave.

Connect With Co-Workers

You spend a large portion of your life with the people you work with. And despite the fact that you are in a professional setting, you likely know a great deal about one another. If this is the case for you, consider inviting one of your co-workers to do something non-work related. For instance, suggest you attend a baseball game together or grab dinner after work. Or, if you share a passion for something like yoga or cooking, suggest you do it together.

Join a Gym

It seems kind of cliche to suggest meeting people at the gym. But people do it all the time. The next time you are in Zumba class or you’re walking on the treadmill, strike up a casual conversation with the person next to you. Then, chat and say hello each time you see each other at the gym. Who knows? You might have the beginnings of a great friendship in the making.

Maintain the Friendships You Make

After you have established a few connections, it’s important to stay in contact. Friendships are like plants. If you don’t water them regularly, they will die. Consequently, make sure you are regularly reaching out to your new friends. Call or text consistently just to see how they are doing. Ask about their life. Show an interest in the things that are important to them. A good friend doesn’t make the friendship all about their needs; but also takes an active interest in the other person.

By Sherri Gordon

Emotionally Focused Therapy, Effective Treatment for Distressed Couples

Therapist
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Emotionally Focused Therapy (EFT) is a short-term (8 to 20 sessions) and structured approach to couples’ therapy developed by Drs. Sue Johnson and Les Greenberg in the 1980s. It is grounded in research while focusing on negative communication patterns and love as an attachment bond.

Attachment Theory

“Attachment” between people typically provides a safe haven: a retreat from the world and a way to obtain comfort, security and a buffer against stress. Attachment also offers a secure base, allowing you to feel safe while you explore the world and learn new information. Its formation begins in childhood with a primary caretaker, such as a parent. Those early, established patterns carry through to adulthood. An “unavailable caretaker” creates distress in a baby akin to an “unavailable partner” creating distress in an adult. Attachment theory provides the emotionally-focused therapist with a “road map” to the drama of distress, emotions, and needs between partners.

Grounded in Science

According to the website dedicated to EFT, a substantial body of research outlining the effectiveness of this treatment exists. It is now considered one of the most (if not the most) empirically validated forms of couples therapy. Research studies have found that 70-75% of couples undergoing EFT successfully move from distress to recovery, and approximately 90% show significant improvements. This recovery is also quite stable and lasting, with little evidence of relapse back into distress.

EFT is being used with many different kinds of couples in private practice, university training centers, and hospital clinics. It is also quite useful with various cultural groups throughout the world. The distressed couples who may benefit from EFT include those where one or both partners suffer from depression, addiction, post-traumatic stress disorders, and chronic illness, among other disorders. EFT has proven to be a powerful approach for couples dealing with infidelity or other more traumatic incidents, both current and past.

Neuroscience also intersects attachment theory and EFT. More recently produced MRI studies demonstrate the significance of secure attachment. Our attachments are potent, and our brains code them as “safety.” According to an article on EFT in Social Work Today, any perceived distance or separation in our close relationships is interpreted as danger. Losing the connection to a loved one threatens our sense of security. “Primal fear” ensues and sets off an alarm in part of our brain called the amygdala, also known as the fear center. Once the amygdala is activated, it triggers our fight-or-flight response. When incoming information is familiar, the amygdala is calm. However, as soon as the amygdala encounters threatening or unfamiliar information, it increases the brain’s anxiety level and focuses the mind’s attention on the immediate situation. People go into a self-preservation mode, often doing what they did to “survive” or cope in childhood. This is the reason we are triggered as adults in our romantic relationships, in the same repeating (and unhealthy) patterns from our formative years.

EFT can help to unwind these automatic, counter-productive reactions.

Fostering Healthy Dependency

EFT provides a language for healthy dependency between partners and looks at key moves and moments that define an adult love relationship. The primary goal of the model is to expand and re-organize the emotional responses of the couple. New sequences of bonding interactions occur and replace old, negative patterns such as “pursue-withdraw” or “criticize-defend.” These new, positive cycles then become self-reinforcing and create permanent change. The relationship becomes a haven and a healing environment for both partners.

Creating a Secure Bond

The process reduces couples’ conflict while creating a more secure emotional bond. Couples learn to express deep, underlying emotions from a place of vulnerability and ask for their needs to be met. Partners begin to view undesirable behaviors (i.e., shutting down or angry escalations) as “protests of disconnection.” Couples learn to be emotionally available, empathic and engaged with each other, strengthening the attachment bond and safe haven between them.

EFT has many strengths as a therapeutic model. First, it is supported by extensive research. Second, it is collaborative and respectful of clients. It shifts blame for the couples’ problems to the negative patterns between them, instead of the couples themselves (or the partners). Finally, the change process has been mapped into a clearly defined process consisting of nine steps and three change events that help guide the therapist and track progress. If you are looking for help with a distressed relationship, an EFT trained therapist would be a wise choice.

There are also several books that might be of interest. Emotionally Focused Couple Therapy For Dummies by Brent Bradley and Jamies Furrow, Hold Me Tight: Seven Conversations for a Lifetime of Love by Sue Johnson, or An Emotionally Focused Workbook for Couples: The Two of Us by Veronica Kallos-Lilly and Jennifer Fitzgeralds are all good places to start.

By Marni Feuerman

Can You Reshape Your Brain’s Response To Pain?

Therapist
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Jeannine, who is 37 and lives in Burbank, Calif., has endured widespread pain since she was 8. She has been examined by dozens of doctors, but none of their X-rays, MRIs or other tests have turned up any evidence of physical injury or damage.

Over the years, desperate for relief, she tried changing her diet, wore belts to correct her posture and exercised to strengthen muscles. Taking lots of ibuprofen helped, she says, but doctors warned her that taking too much could cause gastric bleeding. Nothing else eased her discomfort. On a pain scale of 0 to 10, her pain ranged from “7 to 9, regularly,” she says.

Around 50 million Americans suffer from chronic pain. Most of us think of pain as something that arises after a physical injury, accident or damage from an illness or its treatment. But researchers are learning that, in some people, there can be another source of chronic pain.

Repeated exposure to psychological trauma, or deep anxiety or depression — especially in childhood — can leave a physical imprint on the brain that can make some people, like Jeannine, more vulnerable to chronic pain, scientists say. (We are not using her last name for reasons of privacy.)

Jeannine was eventually diagnosed with fibromyalgia — a condition characterized by widespread pain throughout the body, among other symptoms. The cause is unknown and likely varies from person to person.

The pain Jeannine experienced was physical. She’d feel “lightning bolts, kind of going up through my shoulders to my neck to my head,” she says. Other times, she’d suddenly experience the shooting pain of sciatica in her legs, and she often suffered from a “grinding pain” in her hips. “I would feel like I can’t walk anymore — it was just so very painful to walk.”

Then, about eight months ago, a friend suggested something else — emotional awareness and expression therapy.

Jeannine was skeptical. She’d periodically seen a counselor in “intensive therapy” over the years, and still, her terrible pain persisted.

But EAET, she learned from her clinical psychologist, Laura Payne, is a different sort of psychotherapy. It’s one of several behavioral therapies (among other interventions) included in a report from the U.S. Department of Health and Human Services titled “Pain Management Best Practices.” According to the report, published May 9, “Research indicates that EAET has a positive impact on pain intensity, pain interference, and depressive symptoms.”

EAET was developed in 2011 by psychologist Mark Lumley at Wayne State University and his colleague Dr. Howard Schubiner. It combines some techniques from traditional talk therapies (such as probing a patient’s life experience for insight and context) with those of cognitive behavioral therapy, which focuses more on skills training and changing harmful patterns of behavior.

It’s an emotion-focused treatment, Lumley says, aimed at helping people who are in widespread, medically unexplained pain.

In a 2017 study of patients with fibromyalgia, Lumley and his colleagues found that EAET decreased widespread pain and other related symptoms for some patients. “In summary,” the researchers concluded, “an intervention targeting emotional awareness and expression related to psychosocial adversity and conflict was well-received, more effective than a basic educational intervention, and had some advantages over CBT on pain.”

Lumley believes the treatment might also help patients who have other sorts of pain, though that’s yet to be proved.

So, how does it work?

For starters, as part of the therapy, Jeannine was asked to begin writing in a daily journal, looking into her past to identify when her problems with pain began.

“I wrote down all the different health symptoms I’ve had throughout my life,” she says, “pain-wise, but also other things” — anything that had caused her distress.

For Jeannine, who grew up in an abusive household, there was a lot of distress, and a lot to write about. (We are not using her last name for reasons of privacy.)

“If I was dressed in a way that my dad thought was too provocative, it wasn’t anything for him to call me a ‘whore,’ ” she says, “and he’d call my mother that too.”

The aggression was also physical, she says. “Lots of pushing, shoving, hitting and certainly a lot of belts in childhood.”

It didn’t take much therapy for Jeannine to discover something that startled her. The backaches, stomachaches, headaches and even skin problems she suffered in childhood tended to occur around the same time as the hitting and the yelling.

It was “just amazing to make that connection,” she says. “I had never really stopped to think about it that way.”

As a young adult, Jeannine moved out of the house. The abuse stopped. But her pain didn’t.

Lumley says researchers are finding that this is the case for a number of patients with medically unexplained pain. He says studies have followed people prospectively over the course of years, trying to predict who develops widespread chronic pain.

“They clearly show that difficult life experiences, adverse experiences in childhood are later predictors of chronic pain — widespread pain — years later,” Lumley says.

Jeannine says the idea that there could be a connection between her pain today and the trauma she suffered during childhood sounded “kind of crazy” initially.

“To me it just doesn’t sound logical,” she says. “You think about pain like something [that] hits you. Something hurts; it’s physical. It’s not like something hits you emotionally and then it hurts.” But in fact, that’s exactly how it can happen, researchers say.

“This is a real phenomenon,” says neuroscientist Amy Arnsten, a professor of neuroscience and psychology at Yale School of Medicine. Under healthy conditions, she says, higher circuits in a part of the brain — the prefrontal cortex — can regulate whether individuals feel pain and how much pain they feel.

But these higher brain circuits can weaken and even atrophy when we’re exposed to chronic stress, Arnsten says, “especially stressors where we feel uncontrolled or frightened.”

Fear, depression and anxiety are the sorts of stressors that can weaken these brain circuits, she says, making people more vulnerable to feeling pain. And if those prefrontal circuits aren’t working to help regulate the sensation, Arnsten says, individuals may feel prolonged pain long after a physical injury has healed.

What’s more, without proper regulation, she says, the brain can generate pain when there’s no physical damage. “The brain actually has pathways where it can go down and control our body,” she says, “and actually create a pain response.”

And that pain is very real.

The same thing can happen to adults who suffer trauma, Lumley says. But, when it starts in childhood, that sort of cycle can set in motion a lifetime of chronic pain.

“Most people don’t necessarily outgrow so easily some of those difficult early-childhood experiences,” he says. “Even though one’s life might look good now, people still remain haunted, as memories or thoughts about family come to the fore.”

And that was what was happening to Jeannine at a specific time every day during the week.

“Literally on the drive home, I would start getting pain,” she says.

At first she thought it might have to do with her long commute or maybe how she was sitting. So she got better lumbar support and put “heating elements” in the car’s seat.

But in therapy she realized it wasn’t the car or the commute. It was going home.

“Nothing bad is meeting me here on the drive home,” she says. “But when I was younger, walking home was like, ‘Ahhh, I go back there again?’ It was just a dreadful feeling of ‘Now I have to go back to that environment.’ My house never felt like a safe place for me.”

Fear, she realized, had carried over into her relationships as an adult too, even though she’s now happily married and holds a good management job in a large corporation. She had become deeply hesitant to ever express negative feelings she feared might alienate family, friends or colleagues at work.

“So I decided not to speak honestly. That was my M.O.,” Jeannine says. And that would often be followed by physical pain. In her mind, in such instances, it was easier just to deal with the pain than run the risk of losing the emotional connection with people she cared about.

Today, using the tools of EAET, Jeannine says she has learned how to confront what happened to her as a child and begin the process of healing as an adult. She has learned to be more honest with herself and others about what she really thinks and what she wants.

Lumley says EAET helps some patients look beneath the shame, fear and guilt they may be feeling now to emotions they experienced during the abuse but long suppressed — anger, sadness or distress over the loss of love.

Patients have to face their fears head-on, Lumley says.

“Part of facing it means talking about it, giving it some expression with your words and your face and your body.”

“The insight and perspective we get from therapy can help us feel more in control,” neuroscientist Arnsten says, “and that can put higher brain circuits back online and allow them to regulate our pain pathways, just as they would in a healthy brain.”

Payne, Jeannine’s therapist, says Jeannine’s journey to health wasn’t easy. “It got very tough and the pain got a lot worse, and it became more persistent.”

But Jeannine persevered and worked with Payne to complete all the written exercises and discussions that were part of the treatment.

Just months after beginning therapy, Jeannine began to engage in conversations she had long avoided — being more honest about her feelings with colleagues and her family. “It was the hardest thing I’ve ever done in my life,” she says.

Now, this is a relatively new therapy, and so far the published evidence of its effectiveness is largely based on one study. More research, with larger studies, is needed to truly gauge its worth.

But Jeannine says the therapy worked for her. Today, she doesn’t avoid situations, people or potential confrontations. She’s relieved. And happy. And her pain, she says, is way down. On some days, she has no pain at all.

BY PATTI NEIGHMOND

Lonely People Often Lose The Reflex To Mimic Other People’s Smiles

Therapist
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Loneliness is a “disease”, associated with an increased risk of death equivalent to smoking 15 cigarettes a day. Strides have been made in understanding what form of loneliness is damaging (a lack of close relationships with other people, rather than a lack of relationships per se), but ways to tackle loneliness are badly needed. Now a new study, available as a preprint on PsyArXiv, reveals a way in which loneliness seems to be maintained and, therefore, a potential route to an intervention.

A popular model of loneliness holds that it is maintained by abnormal processing of the social signals – such as smiles and eye contact – that underlie positive social interactions. One consequence of this abnormal processing could be a failure to automatically mimic other people’s facial expressions – a phenomenon that occurs naturally during most social interactions. To investigate for the first time whether this is the case, Andrew Arnold and Piotr Winkielman at the University of California, San Diego conducted a small, preliminary study on 35 student volunteers.

The students first completed three scales that measured their loneliness, depression and personality. Based on the loneliness results, they were classed as either lonely or not lonely. Next they had electrodes attached to two pairs of their own facial muscles important for generating emotional expressions – regions of the zygomaticus major (smiling) muscles in the cheeks, and also the corrugator supercilii (frowning) muscles in the brow. They were then shown video clips of men and women making facial expressions of anger, fear, joy and sadness.

Scales that they were given to complete showed that the lonely and non-lonely students were equally good at distinguishing between facial expressions, and there were no group differences in the strength of “negative emotion” ratings to anger, fear and sadness or “positive” ratings to joy. So the lonely people could recognise and understand emotional expressions just as well as the non-lonely group. However, there were important differences in how their own faces responded spontaneously to the video clips.

When members of both groups saw videos of people displaying anger, for example, their own brows moved to automatically mimic this expression. But when the expression in the video was of joy, only the “non-lonely” group automatically smiled in response. The participants’ scores on depression and on extraversion bore no relation to this finding. It was loneliness that made the difference.

The researchers checked that the lonely group could deliberately mimic smiles, as well as frowns (which they could). They also found that the lonely group smiled automatically while viewing “non-social” positive images (such as nature scenes) that also made the other group smile. These images didn’t include people (or if they did, their facial expressions weren’t obvious.)

The findings suggest that a failure to mimic other people’s smiles automatically could be playing a role in loneliness. A failure to mimic a smile might send an antisocial signal to others, the researchers note, undermining social connections, and leading to social disconnect. “Indeed, this could be one behavioural mechanism that maintains chronic loneliness,” they add.

This is a small study, and it can’t speak to the causal direction: does loneliness lead to a problem with smile mimicry or is it the other way around? But it does suggest a new target for addressing loneliness, and for further research into the role it might potentially play in real-world encounters.

“Given the serious problem of loneliness in society and its danger to health, more research on how it presents in everyday social interactions is useful for greater understanding of and treatment of the condition, ourselves and each other,” the researchers write.

By Emma Young

How the Internet May be Changing The Brain

Therapist
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An international team of researchers from Western Sydney University, Harvard University, Kings College, Oxford University and University of Manchester have found the Internet can produce both acute and sustained alterations in specific areas of cognition, which may reflect changes in the brain, affecting our attentional capacities, memory processes, and social interactions.

In a first of its kind review, published in World Psychiatry — the world’s leading psychiatric research journal, the researchers investigated leading hypotheses on how the Internet may alter cognitive processes, and further examined the extent to which these hypotheses were supported by recent findings from psychologi¬cal, psychiatric and neuroimaging research.

The extensive report, led by Dr Joseph Firth, Senior Research Fellow at NICM Health Research Institute, Western Sydney University and Honorary Research Fellow at The University of Manchester, combined the evidence to produce revised models on how the Internet could affect the brain’s structure, function and cognitive development.

“The key findings of this report are that high-levels of Internet use could indeed impact on many functions of the brain. For example, the limitless stream of prompts and notifications from the Internet encourages us towards constantly holding a divided attention — which then in turn may decrease our capacity for maintaining concentration on a single task,” said Dr Firth.

“Additionally, the online world now presents us with a uniquely large and constantly-accessible resource for facts and information, which is never more than a few taps and swipes away.

“Given we now have most of the world’s factual information literally at our fingertips, this appears to have the potential to begin changing the ways in which we store, and even value, facts and knowledge in society, and in the brain.”

The recent introduction and widespread adoption of these online technologies, along with social media, is also of concern to some teachers and parents. The World Health Organization’s 2018 guidelines recommended that young children (aged 2-5) should be exposed to one hour per day, or less, of screen time. However, the report also found that the vast majority of research examining the effects of the Internet on the brain has been conducted in adults — and so more research is needed to determine the benefits and drawbacks of Internet use in young people.

Dr Firth says although more research is needed, avoiding the potential negative effects could be as simple as ensuring that children are not missing out on other crucial developmental activities, such as social interaction and exercise, by spending too much time on digital devices.

“To help with this, there are also now a multitude of apps and software programs available for restricting Internet usage and access on smartphones and computers — which parents and carers can use to place some ‘family-friendly’ rules around both the time spent on personal devices, and also the types of content engaged with,” he said.

“Alongside this, speaking to children often about how their online lives affect them is also important — to hopefully identify children at risk of cyberbullying, addictive behaviours, or even exploitation — and so enabling timely intervention to avoid adverse outcomes.”

Professor Jerome Sarris, Deputy Director and Director of Research at NICM Health Research Institute, Western Sydney University and senior author on the report, is concerned over some of the potential impacts of increasing Internet use on the brain.

“The bombardment of stimuli via the Internet, and the resultant divided attention commonly experienced, presents a range of concerns,” said Professor Sarris.

“I believe that this, along with the increasing #Instagramification of society, has the ability to alter both the structure and functioning of the brain, while potentially also altering our social fabric.

“To minimise the potential adverse effects of high-intensity multi-tasking Internet usage, I would suggest mindfulness and focus practice, along with use of ‘Internet hygiene’ techniques (e.g. reducing online multitasking, ritualistic ‘checking’ behaviours, and evening online activity, while engaging in more in-person interactions),” said Professor Sarris.

Co-author and director of the digital psychiatry program at Beth Israel Deaconess Medical Center and a clinical fellow at Harvard Medical School, Dr John Torous added: “The findings from this paper highlight how much more we have to learn about the impact of our digital world on mental health and brain health. There are certainly new potential benefits for some aspects of health, but we need to balance them against potential risks.”

Oxford research fellow and study co-author, Dr Josh Firth added: “It’s clear the Internet has drastically altered the opportunity for social interactions, and the contexts within which social relationships can take place. So, it’s now critical to understand the potential for the online world to actually alter our social functioning, and determine which aspects of our social behaviour will change, and which won’t.”

Story Source:
Materials provided by NICM Health Research Institute, Western Sydney University.

Journal Reference:
Joseph Firth, John Torous, Brendon Stubbs, Josh A. Firth, Genevieve Z. Steiner, Lee Smith, Mario Alvarez‐Jimenez, John Gleeson, Davy Vancampfort, Christopher J. Armitage, Jerome Sarris. The “online brain”: how the Internet may be changing our cognition. World Psychiatry, 2019; 18 (2): 119 DOI: 10.1002/wps.20617