• No one will believe you and they will call you a liar.
• I’ll hurt you and your family if you ever tell.
• Everyone will know what a slut you are.
• I’ll do it to your little sister too if you ever tell.
• Your family will know you’re gay and never speak to you again.

• gastro-intestinal complaints
• stomach aches and headaches
• sleep problems
• encopresis
• enuresis

• self-mutilation (burning, cutting, etc.)
• eating disorders
• substance abuse
• sneaking out or running away
• changes in friendship group
• social isolation
• lack of interest in normally pleasurable activities

• The severity of abuse
• The duration of the abuse
• The relationship to the perpetrator

Move it! Move it!

One major cause of irritability is inactivity. The average American spends more than 4 hours a day watching television, or 28 hours per week. If you keep this up until you’re 65 years old, you will have spent 9 years watching television. Experts calculate that it takes 10 years or about 10,000 hours of effort to master a complex skill, like playing piano. Imagine the skills you could develop over a lifetime; oil painting, wood working, pastry baking, martial arts; if you spent 9 years doing that instead of staring at a box.

Get Happy and Rich

Researchers calculate that anger and depression increase and incomes decrease the more television you watch. Television content creators find ingenious ways to keep you fascinated and stimulated.  It takes some serious will power to resist the seduction.  In fact, researchers have found that the average person spends three to four hours a day resisting desires.  That’s a lot of time exercising will power. Researcher, Dr. Roy F. Baumeister, found that the more decisions we have to make the more we deplete our ability to exercise will power. If you’ve been holding your tongue dealing with an angry boss all day, you’re more likely to lash out at your spouse when you get home.

Stop Making Decisions

A good way to keep a ready reserve of self control is to remove the decision making aspect of your goals. For example, if you’ve made a new year’s resolution to exercise more, you might find yourself struggling daily with several decisions. When should you exercise? What will you wear? Are you exercising with a friend? What time will you exercise? What type of exercise will you do? All of these decisions deplete your will power and make you less able to control your temper or practice self-discipline.

Every Sunday, look at your calendar and assign yourself days, times and exercise routines for the whole week.  Pack your gym bag with exercise clothes and have it ready to grab in the morning. Then each day do what you marked on the calendar. No decision to make. Just do it. If you do some aerobic exercise for at least 30 minutes most days of the week, you will increase your self-control reserves, improve your mood and decrease your irritability.

Anger Masks Depression and Anxiety

Moodiness, irritability and anger often mask underlying anxiety and depression. When you feel inner conflicts or frustrations with yourself and others, it often leaks out in anger outbursts that can damage relationships. Researchers found that symptoms of anxiety and depression, (the frequent underlying cause of problem anger), decrease with moderate exercise.

The Miracle Cure in Your Brain

Exercise regulates all of the neurotransmitters in the brain targeted by antidepressants. It wakes up the brain, increasing norepinephrine, which improves energy and self-esteem. When you play sports, run or swim, you boost dopamine, improving your mood, and ability to focus. If you exercise regularly, dopamine storage increases, triggering enzyme production creating dopamine receptors in the reward center of your brain.  These receptors make possible that wonderful feeling of satisfaction when you accomplish something. The more you exercise the more you increase the stable regulation of neuropathways associated with dopamine, overall brain health and control of addictions.

In a famous Duke University study conducted by Dr. James Blumenthal and colleagues, exercise was just as effective as antidepressants in reducing depression. Zoloft and Prozac, two popular antidepressants belong to a group of medications called selective serotonin reuptake inhibitors (SSRI’s).  Serotonin responds to exercise in a similar way as dopamine. It improves mood, impulse control and self-esteem. It also helps reduce stress by counteracting cortisol, the stress chemical.  Serotonin helps strengthen cellular connections in the cortex and hippocampus that support learning.  Exercise costs less than antidepressants and has only positive side effects when performed safely.

Comedian Ellen DeGeneres quipped, “I don’t really need buns of steel. I’d be happy with buns of cinnamon.”  Eating some delicious sweet rolls dripping in butter can give your brain a brief boost of dopamine.  But with the flooding of sugar comes a crash of energy as the body struggles to manage the load.  Taking a brisk walk to boost energy strengthens your heart, elevates your mood and helps you sustain vitality for the rest of the day. For a healthy brain and body, you’ve got to move it, move it.

Photos courtesy of bluegreencommunities and stevengaluh.

From the time an infant is first placed in his mothers arms, then given his first feeding, the mother/child relationship is linked to survival.  An infant reflexively squeezes mommy’s finger, tilts his face toward hers, and the bond of emotional attachment forms.  Nursing mothers release the hormone oxytocin, fostering a warm, relaxed feeling of attachment to the child.  As the baby gains nourishment, the child feels satisfaction and comfort, forming the early food-means-love connection.

Relationships = Survival

In adult life our survival emotionally, economically and physically depends on a complicated web of relationships.  We depend on loved ones to remind us of our worth.  Employers, educators,  and co-workers contribute to our economic survival.  Grocers, health care professionals, security and service personnel ensure our physical survival in a modern society.  Our relationships shape the growth of connections in our brain as neurons form and make new connections based on our experiences.  When you watch your football coach demonstrate a perfect spiral, mirror neurons in your brain’s motor cortex activate as if you were the one throwing the ball.  That helps you pick up the ball and imitate that action.  When your piano teacher shows you the correct fingering of a piece of music, mirror neurons activate auditory and motor neurons in your brain to help you perform the music.

Mirror, Mirror In Your Brain

As you get older, you watch your parents argue.  If they shout and swear when angry, your mirror neurons learn to make that connection when you feel angry.  Living with an angry family member can shorten your lifespan as stress chemicals flood your blood stream, threatening your healthy balance of brain chemistry and hormones.  As you feel angry in reaction to the hostility at home, your arteries narrow, and you can develop gastro-intestinal problems, headaches and other symptoms.  These symptoms feedback to your brain a sense of stress and danger that can keep you tense and angry for a long time.

When you leave home for college and work you bring with you the need for relationships to remind you of your worth, to provide nourishment, mental stimulation and growth.  Unfortunately anger problems can damage your relationships, pushing people away at a time when you need them the most.  Fortunately modern neuroscience shows us how to change our angry reflexes, so that we can protect ourselves without harming the people we depend upon for our survival.

Change Your Angry Brain

Whether you want to learn to throw the perfect spiral, play a Mozart concerto, or break your anger habit, practice makes perfect.  With repetition, effort, and training by experts you can learn complicated tasks throughout your life.  Anger control training requires the same effort, practice and commitment as any other challenging task.  When we practice something regularly over time, the brain wires new connections, making each repetition easier.  Remember learning to ride a bike?  It took all your energy and attention to stay balanced.  Over time it gets easier and more automatic and you use less energy than you did when you were still learning to push one pedal after another.  In our anger and conflict management classes we help people learn new habits to live healthier and happier lives.  Participants report life-changing improvement in relationships and higher self-esteem as they learn to master the anger reflex.  To get started down the path to healing your angry brain, work on these three behaviors on a daily basis.  You can expect to notice some positive changes in your reactivity in a few short weeks.

1. Physical:  Engage in at least 30 minutes of aerobic activity every day.  This lowers stress, increases circulation to the brain, fostering the growth of healthy brain tissue.
2. Mental:  Tell yourself, “I will strive to forgive those who hurt me, as I wish to be forgiven for the hurt I have caused others.”
3. Emotional:  Perform at least one act of unexpected kindness each day for the people you care about.  When we show compassion and kindness to others we strengthen our emotional ties, increasing the flow of positive, stress-relieving brain chemistry.

Get started on these simple changes and notice how you feel.  With practice, you can throw that spiral, play that piano and change your angry brain.

Photos courtesy of colorcritical, Sandersd2006, and DDB UK.

The Power of Imagination

Insanely brilliant and far too young for all of his accomplishments, Neurologist Alvaro Pascual-Leone was the first to map the brain using transcranial magnetic stimulation (TMS).  TMS can turn on or off parts of the brain so researchers can determine the function of a specific brain area.  He performed an experiment to determine if mental practice, or concentrated thought, could produce physical changes in the brain.  He divided a group of piano novices into two groups.  He taught both groups a series of notes on the piano, showing them which fingers to use and allowing them to listen to the notes as they played them.  Then one group, called the “mental practice” group, sat in front of the keyboard for two hours per day for five days.  During this time they imagined playing the notes and hearing the tune.  The second group, called the “physical practice” group, actually practiced playing the music for two hours per day for five days.

The results of this simple experiment proved quite amazing.  The group that performed mental practice alone learned the music as well as the physical practice group and had the same changes in the motor part of the brain as the physical practice group.  This simple experiment points to the power of imagination to produce physical, measurable changes in the brain.  You might ask, “what does this have to do with anger control?”

Imagine this scenario:  you’ve been working lots of overtime hours, even though your young child has been home sick with a babysitter.  You had to cancel doctor’s appointments for some pain you’ve been having, because you don’t want to let your team down at work.  After weeks of this your boss calls you into his office and says, “I have some serious concerns about your work performance.  Several employees have complained about the constant scowl on your face when you come to work.  I have been told to reduce the department by 50%.  I don’t know if I’ll be able to keep you on with this attitude.”

A conversation like this might predictably trigger anger, anxiety, confusion and fear for most people, especially in this economy.  Many of us find ourselves working longer hours for fewer benefits and reduced pay.  To add insult to injury, getting criticized at work after sacrificing your own health and family time for the sake of your coworkers and employer, can shake even the most even-tempered person.  You might imagine telling off your complaining co-workers, throwing a chair at your boss, or any number of angry behaviors in retaliation for this insult.  In a situation like this, it helps if you stop, take a deep breath, and think.

What we regularly imagine shows up in our brain.  If we spend a lot of time with anger and revenge fantasies, we keep our brain in a constant state of arousal.  Over time we clog our arteries, prematurely age, stress our immune system, and feel unhealthy and miserable.  We also strengthen neural pathways for anger and violence, making us more likely to behave badly when triggered.  Indulging in a little self-pity or anger might prove effective in helping you identify your feelings and recognize the emotional injury.  After a few minutes of that it’s best to exercise your imagination to help you get out of the anger.

Hostile feelings pull from the emotional memories of your brain’s limbic system.  You can train your brain to activate your brain’s pre-frontal cortex where you can solve problems and feel better.  It starts with your imagination.  Instead of mentally rehearsing clever ways to tell off your boss, imagine yourself strong, capable, safe and secure.  Calm yourself with thoughts like, “I can handle this.  I can think about this problem and find a good solution.”  Imagine, in vivid detail, the following scenario:

Visualize talking with your boss and coworkers in a mature, adult, calm manner.  With straight posture and direct eye-contact, imagine explaining to them that your unpleasant scowl is due to physical pain, and worry over your sick child.  Imagine that they show kindness and respect and feel guilty about misjudging you.  Imagine your boss experiencing a renewed respect for your incredible dedication and he offers you a promotion and raise.

When we imagine behaving like  strong, capable adults, it produces different neurobiological outcomes.  We stop pumping the stress hormone, cortisol, that ramps up our heart rate and arousal level.  We activate our parasympathetic nervous system to return the body to its normal equilibrium.  We can speed the process of recovery by activating our imagination.

Take a moment, close your eyes and imagine yourself in a beautiful setting.  You feel strong, confident, comfortable and secure.  All your worries fade away, replaced by a sense of peace and comfort.  You smile, activating the pleasure centers of your brain.  You have everything you need.  Safe, calm, and content, this moment feels perfect.

Nature gave us the sympathetic nervous system to allow for quick reactions for self-defense, and the parasympathetic nervous system to return us to calm.  One amazing thing about the human brain is its capacity to heal itself.  Take that conscious effort, put into place self-calming thoughts and images from your imagination.  Exercise these thoughts daily.  Soon you’ll go from worry to calm as quickly as you can imagine it.

Photos courtesy of lloydcrew, grapefruitmoon and Sarah & the spider.

The Nutrition Connection

Matthew burst into my office with a handful of hard candy in his suit pocket and a scowl on his face.  He sat down and said, “I don’t have time for this, but my wife said she’d leave if I didn’t take anger management.”   Matthew grabbed a hard candy from his pocket and began to chew vigorously.  Over the sound of crunching I asked, “What have you eaten today?”  Matthew described a day driving from appointment to appointment with his only nourishment a mug of coffee and a fast food pastry.  “What does that have to do with anger?”  he asked.

Food is a basic ingredient in the formation of natural mood elevating brain chemicals like serotonin.  Serotonin deficiencies cause depression, anxiety, anger problems and eating disorders.  Neurons (brain cells) require food nutrients to make the chemical messengers that influence every system of the body.  Your emotions can instantly change depending on what you eat.  If you grab fast food, boxed, packaged, or processed food, you get a stimulating high from sugar, salt and fat.  Unfortunately a crash follows as your brain is starved of serotonin enhancing nutrients.  The crash causes food cravings that can lead to overeating, weight gain and irritability.

Anger floods the body with stress hormones that, over time, can prove harmful to heart health and other organ systems of the body.  When you start raging at the driver of the BMW that nearly ran you off the road, your heart races, digestion slows, blood rushes to your extremities and sugar floods your bloodstream.  Anger places demands on your body and brain, draining it of energy and resources.  When you don’t replenish with what author Michael Pollan calls, “real food”, the subsequent deficits dive bomb your mood.  This makes you more prone to anger, creating a chronic cycle of irritability and stress.  Matthew’s sugar and caffeine high leads to a crash, making self-control or anger management, nearly impossible to implement.

Real Food

It may sound obvious that you should eat real food, however our modern supermarkets appear dominated by boxed, packaged, processed food stuff largely stripped of its nutritional value.  A loaf of bread may contain calcium sulfate and a box of cereal, pyridoxine hydrochloride.  Not real food.  Michael Pollan, in his helpful book, In Defense of Food, suggests the following for optimal health:

• Avoid food products containing ingredients that are A) unfamiliar, B) unpronounceable, C) more than five in number or that include D) high fructose corn syrup.
• Avoid food products that make health claims.  You can take manure, add Omega-3′s to the nutritional label and pass it off as food.  It’s not real food just because they added some vitamins to it.
• Shop the peripheries of the supermarket and stay out of the middle.  Typically fruits and vegetables, meat, dairy and fish, tend to hug the walls of the market.  All the boxed and packaged stuff dominates the center aisles.
• Get out of the supermarket whenever possible.  Shop farmer’s markets where they don’t sell anything fake or processed and you get foods in season when it’s most nutritious.

Most nutritional guidelines suggest 5 to 9 servings of fruits and vegetables per day.  The U.S. Department of Agriculture (USDA) published new nutritional guidelines last year.  They recommend that 3/4 of your plate consist of plant foods, beans, grains, vegetables and fruits.  The remaining 1/4 of the plate should have fish, meat, or other protein.  Biochemist and nutritionist, Dr. Laura Pawlak recommends 12 servings per day of plant foods.  A serving is 1/2 cup.  Eating this way stave’s off the angry mood of a serotonin starved brain.  Of course a good dose of fruits and veggies doesn’t have quite the kick of a double espresso energy drink.  Dr. Pawlak created a power drink recipe that serves as a great energy booster without the crash and burn of  a caffeine come-down.  This recipe comes from her book, Stop Gaining Weight:  Three No Nonsense Steps to No More Pounds:  Get an attitude, add power brakes, eat more food.   Of course diabetics and others on special medical diets should check with their doctor before trying anything new.

The Shake Brake Formula

banana, 1 large

pineapple juice, 1/2 cup

orange juice or strawberries, 1/2 cup

papaya, pulp of 1 papaya or 1/2 cup papaya nectar

flax oil, 1 to 3 tsp.

blend together and keep refrigerated.

This shake packs a wallop of nutrition giving your brain the food it needs to balance neurotransmitters like serotonin and GABA that help you reduce anger and stress reactions in your body.  Fill a thermos with your shake and sip on it throughout the day when you feel drained or need a pick-me-up.  The flax oil contains omega-3 polyunsaturated fats that provide your brain with serenity rich metabolites that lower hostility and improve brain health.  Our modern diet lacks a balance between omega-3′s, omega-6′s (most vegetable oils)and omega-9′s, (olive oil) from all the different kinds of fats we consume.  Most Americans don’t get enough of the omega-3′s, largely obtained from fish and flax seed.  Increasing real foods that contain omega-3′s can help your brain stay healthy and happy for life.  New research suggests just focusing our attention to healthy choices makes us more likely to choose good real food.  Now I think I need a little power brake.  Better practice what I preach and reach for the blender, not the coffee pot.

Photos courtesy of Natalie Maynor, ilovebutter, and bcmom.

Part I:  Anger and Motivation

Nothing like anger to energize and motivate.  Everyone from the high school football coach to a police officer knows that a healthy dose of anger can push a kid to a touchdown, or help a cop run those five blocks to catch the bad guy.  Some professional athletes, like boxers and basketball players, will try to get pumped up with anger before an event.  Anger and feelings of inferiority often frame the background of a competitive CEO or a movie star.  That feeling, “I’ll show them”, motivates many people to achieve great things.  We fear the destructive effects of anger, (violence, health problems, ruined relationships), but  may not fully appreciate anger’s power to motivate.

Brain researchers found that positive emotions like joy, interest and pleasure are associated with increased activity in the left prefrontal cortex of the brain.  Interestingly researchers looking at anger found that anger, (considered a negative emotion), also triggers increased activity in the left prefrontal cortex.  This puts a wrinkle in the neat framing of;  positive emotions/ left prefrontal cortex;  negative emotions/right prefrontal cortex model.   If anger is so negative, what’s it doing messing around with all these  positive emotions on the left side of the brain?

Dr. Eddie Harmon-Jones, professor of psychology at Texas A & M, worked on a series of studies over the last few years to figure out what’s really happening in the brain during positive or negative emotional states.  Researchers have long known that positive emotions, like excitement, motivate us to move toward something (approach motivation), while negative emotional states, like fear, motivate us to move away (avoidance motivation).  When they discovered the left/right prefrontal cortex connection it began to look like we could help unhappy people by just stimulating the left prefrontal cortex.  Brain researchers keep discovering that nothing neurological is that simple.   When students were made angry in a lab, they showed increased activity in the left prefrontal cortex.  Harmon-Jones and his colleagues determined that the left prefrontal cortex is associated with feeling motivated to act (approach motivation) while the right prefrontal cortex controls feelings that motivate us to retreat (avoidance motivation).  Anger often motivates us to move toward the object of our anger, like when you smash your palm against the vending machine that took your money and didn’t give you any candy.

In another study, Harmon-Jones and colleagues found that anger, and the positive emotion of determination, look very similar to the average person.  Sometimes the expression of anger cannot be distinguished from the expression of determination.  Think of the look on the face of that running back heading for the goal line.  Or what about the look of determination on the face of a teenager confronting a teacher over an unfair grade?

Determination drives us to accomplish a goal.  If directed toward something positive, it can lead to exceptional achievements.  When we work with clients in our Manage Anger Daily classes, they describe regret about their aggressive behavior while angry.  Most got into trouble at work or at home by attempting to control the behavior of others.  When you try to get others to change, you use that approach motivation triggered by the left prefrontal cortex.  This leads to physical or emotional aggression that damages relationships. When you focus on controlling your own behavior, like lowering your arousal, you usually get better results.

How to Lower Your Arousal

Expressions like “calm down, cool your jets, don’t get overheated” express the need others feel to lower the arousal level of an angry individual.  When anger gets triggered the heart rate increases, stomach muscles tighten, digestion slows, sugar gets released into the bloodstream for energy and the body looks overheated.  That arousal can stop our mind from thinking about creative solutions and instead focuses us on the object of our wrath.  To lower that arousal try:

• Deep, slow breathing:  It’s a cliche in anger management that all you have to do is breathe and it will all go away.  This ticks off a lot of anger management clients.  “Don’t tell me how to breathe, I’ve been doing it all my life”, they say.  If you start with deep, slow, diaphragmatic breathing, you send a message to your brain that it doesn’t have to keep pumping all this cortisol to keep you worked up.  Deep breathing doesn’t fix anything, it’s just a start.
• Take a walk:  If your anger gets triggered at work, walk to the restroom to splash some water on your face.  Walking allows you time to think, increases circulation of blood to the brain to help you think straight, and can calm you down.
• Constructive self-talk:  If you say to yourself, “I can handle this”, or “I will calm down first then figure out what to do about this”, you will likely achieve a better outcome.  When you say to yourself, “I’m sick of this”, or “I can’t take this any more”, you’re likely to behave destructively and regret your behavior later.

From Anger To Determination

When you lower your arousal enough to think clearly, you can make room for the idea of a goal.  Ask yourself, “What do I want to accomplish in this situation?”  Once you define a goal like, “I want to negotiate with my boss to get a reduced work load”, then you’re more likely to get something you want.  If you explode in anger at your boss for giving you too much work,  he/she won’t feel very eager to give you what you want. Turn that anger into determination.  Rehearse what you want to say.  Put that anger motivation to good use.  You might just get that touchdown.

Photos courtesy of shockadelic , @edharrison and Monica’s Dad.

As we watch the devastating effects of the recent tornadoes through America, still reeling from the effects of hurricane Katrina, it can stretch the boundaries of our compassion.  We send money for relief efforts, offer shelter to homeless victims and struggle to find meaning in the catastrophe. Global Climate Change scientists have been predicting fierce storms like these for decades.  I remember reading about Global Warming in the 1970′s.

Psychologists help survivors cope with trauma and provide advice to organizations to reduce conflict and encourage collaboration.  Scientists predict stronger, more frequent and brutal storms, as ocean temperatures rise.  The term, Global Warming does not adequately describe the changes facing our planet.  Climate Change, the latest label, comprises a number of changes accelerated by human impact on the environment.  Some feel Global Disaster is a more accurate label to describe what we face as a species.  By burning fossil fuels, cutting and burning forests and destroying natural habitats, humans have increased the average global temperature significantly beyond the range of 10,000 years of human history.  The ripple effect of this average temperature increase causes a loss of polar ice, melting of glaciers, rise in sea level, acidification of the oceans, and destruction of species habitats and ecosystems.

Big storms can wipe out crops, destroy communities, threaten the availability of water and increase the threat of disease.  Groups of scientists from many disciplines including oceanography, biology, environmental science and technology, continue to submit research on the current effects of climate change, and create models to reduce the devastation to our planet.  The Intergovernmental Panel on Climate Change won the Nobel Peace Prize in 2007 for it’s efforts to educate and collaborate to help humans adapt to the massive changes we face.  Check out their website, read some of the research, and look at maps of the world and scientific projections.

Psychologists know a lot about how hard it is to get people to change.  We recognize denial in the alcoholic and resistance in the obese patient.  Unhappy couples won’t give each other more love and parents refuse to discipline their unruly children.  Dr. Robert Gifford of the University of Victoria published an article in the latest issue of American Psychologist (entirely dedicated to Global Climate Change). In this article he describes the psychological barriers that keep us from acting in the interests of our own survival.  I’ll share a few of these “dragons of inaction” with you.

• Limited Cognition:  We’re ignorant in two ways:  we don’t know the problem exists, and we don’t know what to do once we’re aware of it.

• Ideologies:  Religious and political ideologies create a “you-can’t-tell-me-what-I-don’t-want-to-believe” kind of problem.  Capitalists want to drive the free market, even if it means destroying forests, fisheries and habitats around the world.  Others find solace in religious beliefs that discount any science that conflicts with their views.  Technosalvationists imagine a world where we can cover buildings with algae and create artificial trees to save us from doom.

• Comparisons with other people:  Many of us think, “Why should I change if they won’t change?”  If China and India won’t sign the Global Climate Change Accord, then why should we?  I get this a lot in marital therapy.  “Why should I behave lovingly if he/she isn’t?”  The obvious answer, “Because it will make your marriage better” seems to escape them.

• Discredence:  When we dislike the views of others we’re unlikely to take advice or direction from them.  People who make their living from the oil and gas industry don’t want to hear from environmental scientists.  When we don’t trust the source of information we can’t be persuaded by that source.  Then of course we have denial.  Many outspoken individuals deny Global Climate Change or deny that humans play any role in that change.

• Perceived risk:  Financial risks certainly prevent many of us from changing our behavior to help the planet.  Though I’d love to put solar panels on the roof of my house, the cost makes it less of a priority than funding my child’s college education.  Security risks prevent many of us from buying tiny fuel efficient cars that crunch more severely than that hefty SUV.  Social risks prevent many men and women from buying hybrids.  Will my buddies think I’m a wimp?  Will my friends at the Republican fundraiser think I’ve turned Democrat?

I’m an optimist.  I know my obese patients can and do lose weight, and those unhappy couples can and do learn to love again.  We’ve reduced car accident deaths by getting people to wear seat belts.  Cigarette smokers quit smoking and reduce their cancer risk.  Behavior change, while difficult, is still a normal part of our human experience.  In my lifetime I’ve had to learn to use a seat belt, computer, cell phone and the bane of my existence, automated ATM machines.  I’ve learned to recycle and bicycle.  Change starts with information.  The Nature Conservancy provides a free carbon-footprint calculator.  It can help you reduce the negative mark you make on the planet.  Or you can do what Comedian Jimmy Kimmel suggests and just switch from Fahrenheit to Celsius.

Photos courtesy of Gerard Van Der Leun and USACE public affairs photo stream.

L. F.  In 2003, one of my loved ones entered treatment for alcoholism, and I found myself plunged into a world with terms like addiction, alcoholism, adult children of alcoholics, codependency, dual-diagnosis, and on it went. [I soon admitted that I'd experienced decades coping/fighting with family members and friends' alcohol abuse and/or alcoholism.] To answer my questions — namely, “How could it possibly be a disease; they choose to drink?” and “Why have I put up with it for so long!?,” I immersed myself in research and my own recovery work (e.g., therapy and 12-step programs for family members) and found there was a whole new body of knowledge (much published in just this century) – thanks to new brain imaging technologies. It was this new research that I wanted to share in the hopes I could help other family members/friends who struggle with a family member’s drinking and to help all of us, as a society, end the stigma and shame that surrounds and perpetuates the disease.

L. F.   I would say it’s the brain disease nature of addiction and that chemical and structural changes occur in the brain as a result of alcohol abuse and alcoholism. Given the brain controls everything we think, feel, say and do, brain changes caused by alcohol abuse or alcoholism cause people to behave in ways they normally would not behave, such as: arguing with family members or friends about the drinking, yelling at or hitting family members, missing work, carrying on rambling arguments, accusing family members or friends of doing things they haven’t done, driving while under the influence, being super nice, or continuing to use/drink after promising not to. We call these things drinking behaviors. Understanding that alcohol misuse (abuse or alcoholism) causes the drinking behaviors; that it is not a behavioral choice once the brain changes are activated, helps all concerned better appreciate that: 1) the alcohol misuse needs to stop in order to stop the drinking behaviors, and 2) the non-drinker has no control over the drinking behaviors caused by a person’s alcohol misuse-related brain changes.

To identify possible alcohol misuse (alcohol abuse or alcoholism), start with a single question. How many times in the past YEAR have you [male] had more than 5 drinks per day? [Insert 4 drinks, if female. Drink defined as 5 oz. of wine, 12 oz. of beer, 1.5 oz. of hard liquor.] If the answer is once or twice, that person is engaging in “at-risk” drinking – the type of drinking that can lead to alcohol abuse and/or alcohol dependence (alcoholism). By the way, “normal” or “moderate” drinking is defined as: no more than 7 standard drinks/week, with no more than 3 of the 7 in a day for women; and for men, it is no more than 14 standard drinks/week, with no more than 4 of the 14 in a day.

L. F.  First it is important to really understand the answers to the above questions.  Secondly, it is to understand that coping with a person’s undiagnosed, untreated, not openly discussed drinking behaviors causes secondhand drinking/SHD (similar to the idea of secondhand smoke). SHD activates the fight-or-flight system in the body of the non-drinking family member. When the fight-or-flight system is chronically activated, a person experiences brain changes, changes that in turn can cause behavioral changes, such as unhealthy coping skills. This chronically activated system can cause emotional and physical ailments, such as depression, anxiety, headaches, backaches, and stomach problems. My most recent book, Loved One In Treatment? Now What!, helps family members understand this dynamic and how to stop it.

Thirdly, it’s understanding they are not alone. Over one-half of American adults have a loved one with a drinking problem, and one in four children will live with alcohol abuse or alcoholism or both before the age of 18.

SHD can be identified with a single question, as well:  In the past year, has any male in your family had five drinks in a day (or any female had four)? If you answer, “Yes,” you’ll want to learn more.

L. F.  One of the most difficult aspects with regards to alcoholism is to understand that it is one of the diseases of addiction, which is defined as a chronic, often relapsing brain disease. To that end, it is helpful to realize that everything about our body – what we can see and what we cannot see – is made up of cells. Diseases change cells in our body — that’s what makes a disease a disease. A disease might change cells in body organs (like the heart or liver or eyes) or in body organ systems (meaning several organs working together), like metabolism or cardiovascular. For example, the disease of breast cancer attacks cells in the breast and the disease of diabetes, attacks cells in the metabolic system. The diseases of addiction (drug addiction or alcoholism) change cells in the brain, thereby changing how the brain works. Brain cells that control our emotions, memories, learning, motivation, and judgment are the most deeply affected. Additionally, alcoholism often change cells in several other body organs, as well, such as the liver, heart, and kidney. Like other diseases, if untreated or during a lapse in management of the disease, a person can die from alcoholism, just as people die from other diseases.

Something else for skeptics to understand is that while brain changes occur with both alcohol abuse and alcoholism, one of the characteristics of the disease of alcoholism (or an addiction to another drug, for that matter) is cravings. An addiction craving can be five times stronger than our instinctual, hardwired drive to eat food when hungry because of the neural networks that are compromised. These powerful cravings override all other “thought” and are what cause an alcoholic to lie and steal and do whatever it takes to drink. The other three characteristics of the disease are tolerance, loss of control, and physical dependence.

It is helpful to understand the key risk factors that contribute to a person “crossing the line” from alcohol abuse to alcohol dependence (alcoholism). These risk factors include: genetics (if it runs in the family, genetic predisposition); social environment (where heavy drinking is viewed as “normal” and encouraged);  childhood trauma (verbal, physical, emotional abuse – which “wires” unhealthy coping skills and brain changes); early use (critical brain development ages 12-25 makes the brain especially vulnerable to brain changes caused by alcohol misuse), mental illness (e.g., depression, anxiety, ADHD, PTSD, bipolar – which also cause brain changes and the potential to “self medicate” with alcohol). The more risk factors, the more susceptible a person’s brain is to the chemical and structural brain changes caused by alcohol abuse and the possibility of “crossing the line” to alcoholism.

L. F.  It is a critically important concern. Once a spouse understands the brain has been changed, they can appreciate that sticking to the terms of any kind of deal making (such as not having more than one drink if you’re going to drive with the children) is likely not possible if the person is an alcoholic — you just never know. Therefore, the non-drinking spouse needs to set up safety plans and explain those to the children and to the drinking spouse (when he/she is sober).

In both of my books, I have a chapter on what to tell children, but basically, it involves an age appropriate description of alcoholism. It is also important to separate the drinking behaviors from the “person.” Helping a child understands that alcohol changes how the parent’s brain works can help that child understand that it is those brain changes that makes their parent act differently or seem not to love them. Children need to understand this and that it is not “them” (the child), nor anything they’ve said or done.

But, back to the safety plans… one safety plan is that the child will not be driven (ever) by the drinking parent until the parent gets demonstrated help with their drinking — “demonstrated help” is a whole other topic, unfortunately.

L. F.  The effects are extensive, as described above, and they can set a child up for several of the risk factors I described when the drinking is not openly, honestly acknowledge, discussed and productively dealt with. The latter refers to the notion that denial, secrecy, blaming, shaming, nagging do not work when trying to cope with a loved one’s drinking and subsequent drinking behaviors.

Another part of this is to understand what happens to the non-drinking parent. Their behavior changes, too, as a result of  brain changes caused by the chronically activated fight-or-flight system; behavioral changes that can also be confusing to children. For example, a mom feeling anxious when dad is late (fearing he’s out drinking), may start to snap at her children — something she would not do were it not for her anxiety over whether her husband stopped for a drink on the way home from work. So parents need to understand SHD and how to treat/prevent it, which is one of the key subjects in my second book, Loved One In Treatment? Now What!

- Of further note, all alcoholics go through a period of alcohol abuse, but not all alcohol abusers become alcoholics.

- A person does not have to “hit bottom” to get and/or to be encouraged to seek help. In fact, the sooner the drinking pattern is interrupted, the better for all concerned. Nagging, shaming, blaming DO NOT work, however, which is why it is so important to learn about alcohol abuse and alcoholism.

- To anonymously assess a loved one’s drinking to see if it’s really a problem, go to NIAAA’s website, “Rethinking Drinking.”

- To better understand alcoholism (or any addiction), visit www.hbo.com/addiciton. It is an EXCELLENT resource and is produced by HBO in collaboration with NIAAA, NIDA and the Robert Wood Johnson Foundation.

G. S.  Thank you, Lisa, for this interview, and for sharing this helpful information.  I provided you readers with links throughout this interview if you wish to read some research supporting Lisa’s work.  If you find yourself in a relationship where drinking becomes a problem, get help as soon as you can.  You can find help from Al-Anon family groups, and your teens can find support from Alateen.  These groups, in addition to counseling, can help prevent the damage Lisa described from “Second hand drinking.”

Photos courtesy of Seegul and Rikmoran.

I heard an old joke that still makes me laugh.  An old lady in a red Rolls Royce drives into a crowded shopping center parking lot.  She waits for an old truck to pull out so she can drive into that space.  As the truck pulls out, a young man driving a blue Porsche speeds around the old woman and takes her parking place.  The young man hops out of his car, flashes a grin and says, “that’s what you can do when you’re young and fast.”  He struts off to the store.  The parking lot clamors with the terrible sound of crunching metal.  He turns around to see the old woman push his car out of the parking space and replace it with her now dented Rolls Royce.  She slowly gets out of her luxury automobile, smiles and says, “That’s what you can do when you’re old and rich.”  If we’re lucky enough to reach old age, we’ll hopefully retain our sense of humor and dignity in a world that values youth and speed over wisdom and experience.

We can learn a lot from spunky old people.  I met a 93 year old woman and her much younger senior friends as they volunteered at a local theater.  Ann said “I walk my dog two times a day.  I have one fat knee and one skinny knee.  I get aches and pains like everybody else but I keep them to myself because they’re mine.”  She plays piano for her church choir, keeps in touch with family on Facebook, and nurtures close relationships with family and friends.  You could easily picture her living well beyond 100 years of age.

Research on centenarians, those who’ve lived a century or more, shows they have several characteristics in common.  Blue Zone researchers call it the “Power 9“.  These traits can add 12 or more years to your life.  Exercise gives you 4 years.  Having a purpose, and healthy ways to cope with stress adds another 4 years.  If you eat right, and drink no more than 1 to 2 alcoholic beverages a day you get 8 more years.  You can gain 4  more years by belonging to a social group, church or community.  Centenarians put their loved ones first, and they tend to connect with positive friends and acquaintances throughout their lifespan.  If you go to the Blue Zone website you can take tests to measure your biological age, life expectancy and get some tips on how to increase your healthy life expectancy.

I took the Blue Zone test.  I learned that my biological age is several years younger than my chronological age.  My life expectancy is 95.8 years (better call that insurance agent) and my healthy life expectancy is 83.6 years.  I accrued 12.9 years because I have a healthy lifestyle (regular exercise, lots of vegetables, no smoking, etc).  The website says I can earn another 2.9 years by eating more fruit, getting better sleep, and spending more time with friends.  My loyal friends will attest to the truthfulness of that item.

We need loved ones, belonging, exercise, fruits and vegetables, and some sense of purpose for optimal health.  John,  40 years of age, overweight, cranky, with high blood pressure and a temper, came to my office for help.  I recommended some lifestyle changes. He winced and groaned, “I can’t change everything I do.  It’s too much.”   I said, “John, you feel depressed and stressed because you treat yourself like garbage.  Let’s talk about one thing thing you can do everyday to improve your health.”  John agreed to start walking every morning before work.  The following week he said he felt better.  I shared with him the Japanese principle of kaizen.  This comes from the word kai meaning change, and zen which means good.   Kaizen means that small changes add up to a lot over time.

So if you want to live a long, healthy, happy life, start with small little changes in your lifestyle.  You don’t need an extreme life make-over to get healthier and happier.  In fact, extreme changes don’t add years to our lives, so don’t bother with that.  Take the Blue Zone Vitality test to identify ways to slowly improve your longevity.   Pick one new healthy thing and make a commitment to do it everyday.  At the end of the year you’ll notice the scale tipping in the right direction, your ab muscles will ripple, and your friends will appreciate all the attention.  That reminds me, I better go eat a banana and call a friend.

Photos courtesy of srqpix and farhad_omar.

Fans of the television show, The Office, recognize the character, Dwight Shrute, a rigid, aggressive, authority-obsessed bully.  Dwight, (played by the wonderful actor Rainn Wilson) regularly pounces on co-workers, both verbally and physically, to prove his superiority.  We talk to managers and employees who describe painful encounters with aggressive, inflexible, co-workers.  These Dwight Shrutes necessitate hours of strategic planning because of the threat they pose to workplace harmony and efficiency.

Recent research found both structural and chemical changes in the brains of aggressive people.  Aggressors show lower levels of serotonin, (a neurotransmitter associated with depression) and some structural deficits in the frontal parts of the brain necessary for regulating impulses.  Researchers at the University of California, San Diego, found changes in the brains of victims of aggression.  A lot of research demonstrates that victims of aggression are vulnerable to stress-related disorders such as anxiety and depression.  Victims also face susceptibility to viruses and bacterial infections due to stress on the immune system.

Surprisingly, aggressors also suffer from the effects of their own behavior.  Aggressors can become hyperactive, and face increasing threats to immune system health with each subsequent episode of aggression.  Stress hormones cause negative health outcomes for aggressors and victims alike.  Stressful social interactions in the workplace also impact witnesses to the aggressive interaction.

One of my clients had to leave her workplace on stress disability because she witnessed an act of violence at work.  An angry boss threw her colleague to the ground.  In the aftermath of the incident the boss was not punished and the co-worker did not press charges.  This lack of attention to the extreme aggressive behavior made my client feel unsafe at work.

When we witness an act of aggression, brain cells called mirror neurons recreate that incident in our own brain.  When we witness the horrors of war, or natural disasters such as the recent devastation in Japan, our brain registers a smaller version of the trauma.  Our mirror neurons stimulate compassion that motivates us to want to help others.  We humans depend on social relationships for support,  comfort and companionship.  One aggressive employee can disrupt the entire operation of a company and it’s underlying social structure.  Aggression also harms the aggressor.  I offer a few suggestions to stop workplace aggression and disarm the Dwight Shrute in your workplace.

Sweat the Small Stuff

When your Dwight ridicules a co-worker in a meeting, take action as soon as possible.  Low level verbal aggression, left unchecked, tends to escalate.  Take Dwight aside and require him to apologize and rephrase his remarks using respectful language.   Social scientists found evidence to support what they call The Broken Window Theory.  They found you can prevent and lower the rates of vandalism in a community by fixing the low level problems, namely the broken windows, quickly.  Punishing vandals and repairing the damage quickly creates and maintains a social norm that contributes to a better behaved society. (Critics refuted some assumptions of this theory.  However, managers who set and enforce appropriate social norms can prevent much bad behavior).    When leaders address low level problems quickly, they set a standard for the norms of the workplace.  While this takes more time than you want to spend on the front end, it saves hours of time and lots of money on the back end if you face a workplace violence claim against your company.

Listen to the Whiners

Every workplace possesses at least one annoying whiner.  This person shares their irritation about the front desk clerks  perfume, complains about the uncomfortable workstation and fumes over food stolen from the company refrigerator.  While we feel tempted to avoid the constant barrage of complaints, this person often can be the canary in the coal mine warning of potential  disasters.  Many workplace conflicts begin with minor slights and silly discomforts.  Uncomfortable workstations can lead to injuries.  Physical pain makes people cranky and aggressive.  Perfume allergies can effect the breathing of some sensitive people and make them feel negative emotions toward the offender.  When someone with diabetes or special dietary considerations finds their food missing from the refrigerator that can provoke a hostile incident.  When management addresses these issues and with policy standards and enforcement, it lowers the social stress and makes aggression less likely.

Work at Play

Occasionally bring an attitude of playfulness into the workplace.  A bulletin board where employees can post jokes and cartoons, a corner of the lunch room with a sponge ball and mini basketball hoop, employee awards parties and other fun activities increase morale.  Encourage posts on Rainn Wilson’s inspiring  Soul Pancake blog.  Occasional shows of random appreciation, particularly if combined with a little fun, will reset the brain, buffer the negative effects of stress, and make people feel better.  Happier employees are less likely to behave aggressively.
Managers feel a lot of pressure in this economy to produce more with less.  That pressure often makes managers even more impatient with the complainers and bullies in the workplace.  A little bit of early intervention can help both managers and employees feel more effective, productive and successful.  If you need help with a workplace issue,  feel free to contact us.  We would love to help you achieve a happier and healthier workplace.

Photo courtesy of The Cleveland Kid