Reverie

Anxiety and Screaming Babies

2011-09-10T16:38:00.000-04:00

I was minding my own business in one of those warehouse shopping stores when suddenly I was assaulted by an eardrum shattering wail that made my skin crawl. A crying toddler, possibly the most painful sound known to shoppers worldwide. “Where is that dang baby’s mother!” I counter wailed in my head. “Make it stop!” Then you see the mother and father shopping, talking and looking as if there is no shrieking siren blasting us from their cart. What is that?? Do they not know I can’t take it any longer!! Well the truth is nothing like that. It is habituation actually. What I am tempted to think of as bad parenting is simply the process of getting used to something. At first it is terrible but with exposure it becomes a non-event essentially. Those parents hear the child but are not bothered anything like someone who is first hearing the mind-numbing symphony. That is why exposure for certain types of anxiety is crucial for getting over it. At first it seems terrible but if you stay with it, it stops bothering you. These parents have accepted that loud sounds will blast from that little one at random times and have become so used to it that it is hardly on the radar. In the same way, if you accept the anxiety and willingly feel it, then you will get used to it and it will stop being an issue.

Glad that wasn’t my baby.

Medical News: Fertility Treatment Not Affected by Stress - in OB/Gyn, Infertility from MedPage Today

2011-02-26T17:04:00.000-05:00

Medical News: Fertility Treatment Not Affected by Stress - in OB/Gyn, Infertility from MedPage Today

The Pain of Exclusion

2011-01-23T15:30:00.000-05:00

Interesting summary of article on Ostracism (or feeling left out)

I guess it goes without saying that no one likes to be left out, ignored or rejected. However, there were some surprises in the summary of research in this article in Scientific American. Here were the highlights

There is a surprisingly powerful emotional response that is swift and strong. If someone says that what other people think doesn’t matter, well, that is very unlikely.
The effect is across the board. Everyone gets hurt and it doesn't make a huge difference if you care about the person who blows you off or not. Nor does it matter if you know them or not, it still hurts.
The initial pain is similar no matter how tough or sensitive a person is or claims to be. It really hurts a lot.
Personality traits influence coping and recovery but not initial pain. For example, socially anxious people take a lot longer to recover but are NOT hurt more than anyone else at first.
Right after feeling hurt a huge psychological effect is evident. It influences meta-frames or our big assumptions about: general belonging, self worth, life’s meaning, control, sadness and anger. All of these take a hard turn toward the negative until a person begins to recover.
Apparently this experience happens quite a bit.
There is an urge to escape or fight back (get even) or there is an increase in desire and behavior to be included.
Feeling ostracized physically hurts. In one study, subjects were given regular doses of an over-the-counter painkiller and their response to the rejecting event was reduced.

Between Heaven & Hell (excerpt)

2011-01-11T10:23:00.000-05:00

10 Insights from Psychological Research In 2010**

2010-12-30T07:43:00.000-05:00

To break a bad habit focus on stopping the behavior before it starts by vigilant monitoring of any hint of the behavior. Don’t do it!
Touch impacts mood. If things around you “feel” good to your touch your mood will generally be better.
People are generally bad at estimating how long something will take to do. People in power are the worst. To improve be honest about obstacles, how long did it take before and be realistic about sub-tasks.
To be happier, learn to savor day-to-day experiences. (Rich people seem to lose the ability to do this)
Engaging in simple acts of willpower requiring small amounts of self-control significantly increases your overall self-control and willpower.
Being generally pleasant (agreeable), responsible and even-tempered are the most important personality traits to a have a happy relationship.
Holding powerful poses or postures actually makes you biologically more powerful. Spread your limbs wide, stand up straight and lean into conversations.
If you want to gauge how “in-love” someone is, look to spontaneous in-the-moment acts of kindness and generosity, like saying “I love you,” offering a back rub, or surprising your partner with a gourmet dinner – not so much in ways that require forethought, planning, or memory.
It is easier to cut your losses if you take the view of what will be gained with stopping rather than focus on what is lost.
The best way to deal with conflict is to determine how serious the problem is. Things that aren’t so big are better being just dropped. Major conflicts are better if faced and talked about.

**Read this article for a complete summary

The Top 10 Psychology Studies of 2010 by Heidi Grant Halvorson, Ph.D.

http://www.psychologytoday.com/blog/the-science-success/201012/the-top-10-psychology-studies-2010

The Power of Apology

2010-09-26T19:08:00.000-04:00

In the practice of psychology there are certain statements that stand out. This is notable because psychotherapy is generally about very intense and often troubling issues. Frankly, you get used to dramatic things. Nevertheless, I still find the following statement remarkable whenever I hear it.

"I can't ever remember (person's name) saying, 'I am sorry'. They never apologize." I have to ask, "Never?"... "Yes." "Ever?" "Yes." "Really?" "Yes." "Wow." That is an extraordinary statement. The inability to apologize is absolutely disastrous for relationships. Disastrous. First of all, it is impossible to not offend. The simple absolute fact is that we are all annoying at times. To not apologize suggests a striking commitment to deny this obvious reality. It is profoundly unrealistic if not dishonest. What makes it so hard to apologize?

Most of us are not so self-deceived that we would refuse to ever apologize; yet, a genuine heartfelt apology can be extraordinarily difficult. Think about it, is this hardship worth the loss of a relationship? Why is the choice to walk away made so often? Why do we do this?

An apology contains the cure for a wounded heart. It is carrying the power to heal into the soul of another person. I think heal is the right word for this. When an apology is offered by a person who is truly sorry, this powerful act can remove obstacles that previously seemed insurmountable. What are the psychological obstacles to this?

Apology withheld as "ransom" until the other person apologizes. I will apologize if they apologize! Actually, offering an apology is far more likely to be reciprocated with an apology in return.
Fear that if you give an inch they will take a mile. If I apologize then I will really get my nose rubbed in it. If you hurt someone then take your lumps.
Concern about all or nothing. Sometimes a person may still think they are right. Apologizing would feel dishonest. However, you can apologize for how you acted. Frankly, in almost all fights it is not so much what you say (unless you are being mean) but how you say it.
Gotten burned for not doing it right. Sometimes an apology is not accepted or criticized. Usually, it is because it is not really a full apology. Appeasing is not apologizing.
Secretly afraid you are "rejectable." If you fear that someone's distress at you could lead to rejection than you are going to try and prove them wrong. Frankly, this backfires. Your defensiveness is probably far worse to that person than anything you were imagining.
Chief of all sins, pride. Feeling superior and contemptuous of other people will form a self-protective shield around you. Stand back and look at your life. Eventually people will move away from you. You want to really be respected and honored? Try humility.

An apology is the risk of love. The other person already knows you are a mess. They won't run in horror if you admit your flaws. They will actually move closer because this humility makes you safe. I will know if you hurt me you will fix it. That is safe!

Frankly, it is not the mistakes we make that break up relationships but our unwillingness to own our flaws. If someone is unwilling to admit to their mistakes they are not hard to be with, they are impossible to be with in any meaningful way. Eventually people will just "manage" such a person and avoid intimacy and self-disclosure because that person is not safe.

Many things in life are paradoxical. For example, fear is solved by facing it rather than doing what seems natural, i.e., avoiding it. An apology feels like in invitation to humiliation and rejection but it actually leads to respect and intimacy.

Having a fight at night

2010-07-15T21:33:00.002-04:00

A lot of people, including myself, consider the Bible as inspired by God and aspire to live accordingly. There is a statement in the New Testament: do not let the sun go down on your anger. This is interpreted to mean don't wait until the next day so you won't harbor anger. Actually, I think it is subtly changed in our minds. What it becomes is, "don't go to sleep with anger." It does not say that. I want to propose a different way of thinking of this that is closer to the wording. If the sun has set, too late. You have to wait until sun up to deal with the anger. It is almost always disastrous to fight when you get in bed to sleep. Have you not slept on something and the next morning have a much better perspective? Is that a contradiction of the Bible's wisdom? I don't think so. After sunset our physiology begins changing as we calm and prepare for sleep. That neurological state is terrible for fighting. Fighting well requires self-control, preparation if possible, and enough alert time to resolve it. Fights are inefficient. If you artificially bind your time by starting when exhausted the pressure increases. Usually the offended party has been mulling over the issue which means thinking it through and answering possible objections. That is an unfair advantage and usually evokes defensiveness. So consider this. After sunset wait until the sun is back up to try and solve the problem. What do you think?

2010-07-13T14:14:00.001-04:00

Interesting article on the meaning of bizarre dreams. http://ping.fm/wDOe4

2010-06-15T19:19:00.001-04:00

God will do nothing Himself that He can possibly delegate to His creatures. (Peter Kreeft) Maybe this is why He doesn't relieve anxiety sufferers with a sudden cure because they can find their way.

2010-05-26T21:58:00.001-04:00

A+ article on why breathing correctly crucial in curing anxiety. http://ping.fm/Ya2lW

2010-05-12T15:49:00.001-04:00

Music Soothes Anxiety as Well as Massage Does. http://ping.fm/yOiq2

2010-03-12T17:09:00.001-05:00

is sending this as a test of this cool app from ping.fm that posts to all my networks.

How to Distinguish Normal Fear From Anxiety Disorders in Children

2010-02-14T20:55:00.000-05:00

It can be quite difficult for a parent of a child demonstrating fear, worry or anxiety to tell the difference between normal childhood fears and those that are or could become psychological issues. In my practice, I frequently deal with adults with anxiety disorders that started in their childhood but went undiagnosed and untreated. It wasn't bad parenting, it just got missed or was misinterpreted. The sooner problematic anxiety can be treated the better.

Everyone goes through a series of developmental stages throughout their entire lifespan. Characteristic of childhood development are certain kinds of fears that any child is likely to experience and are part of a normal developmental process. Children grow out of these fears as they mature unless for some reason they become problematic. Generally speaking the most common fears for these stages are as follows.

Age 1 - 3

fear of strangers-evokes withdrawal, crying, clinging
being neglected
loud unexpected noise

Age 3 - 5

new and unfamiliar environment
threat to safety and security
dogs
bugs (such as spiders and roaches)
the dark
imaginary characters such as monsters

Age 6 - 10

school
dangers outside of home
realization that not always protected
stranger danger
illnesses
tragic events in the media
lightning and thunder
personal safety

Age 10 - 13

academic and athletic performance
personal and social success
making and keeping friends
social criticism
environmental danger like thunderstorms, earthquakes and floods
parents and loved ones getting hurt or dying

Age 13 - 18

acceptance or rejection in social relationships (primary fear)
the future
moral issues-guilt
issues about dating
career choice
not being independent
personal injury

Generally, younger children are afraid of physical events and imaginary creatures, while older children are more fearful of social issues. There are some fears that cross all developmental stages. Fears related to illnesses, pain, medical and dental procedures, doctor visits, natural disasters, war and any kind of traumatic event are likely to evoke anxiety regardless of the developmental stage.These stages should not be considered as absolute. Instead they provide a general guideline. Developmentally some kids may be ahead or behind a couple years and that's unlikely to be an issue. On the other hand, for example, a 14-year-old child who is still afraid of the dark and requires a night light may be more anxious than normal. Fear and anxiety often don't follow the expected course and for whatever reason sometimes "sticks" around but wouldn't necessarily be considered clinically significant. Therefore, even more important than the particular content of the fear are the following characteristics. In an attempt to make it easier to remember, I'll start them all with the letter S.

Surplus Does the anxiety seem out of line with what most people would think a "fitting" reaction? Is there a significant surplus of fear and worry relative to the danger? Is your child frequently unable to stop or control the worry or fear? Does your child have an exaggerated sense of danger or threat?
Storm Does your child to get very distraught or easily upset? Is the worry and fear such a burden or nuisance that your child seems unhappy or miserable because of it? Does the emotional reaction seem like an intense storm?
Spoil Does the fear and anxiety significantly interfere with his or her daily activities or that of the family? Does it significantly impact sleep, school, friendships or the ability to act independently? Is it spoiling your child's life to some extent?
Stuck Does the fear last far longer than you would expect? For example, has your child worried consistently for a couple months? Is the fear present most everyday or fairly frequently? Is it persistent to the point where you're wondering if it's stuck?

Sometimes it is hard to measure these characteristics because it is not always clear what to use as point of comparison. First, consider what has been typical for your own child. Does the anxiety seem like a significant break from their normal behavior? Second, but be careful of this, consider what seems typical of other children in similar life stages. If you are still uncertain, it is highly recommended that you get a professional assessment. One thing that is certain about anxiety disorders, the sooner they are addressed and treated the shorter and less troubling they are for your child.

The following references provided the research data used for part of this article:

Beidel, D. C., & Turner, M. (2005). Childhood anxiety disorders: a guide to research and treatment. New York: Routledge.

Wagner, A. P. (2005). Worried no more: help and hope for anxious children. Rochester: Lighthouse Press.

How to Help Your Anxious Child - Expectations

2010-02-14T20:06:00.000-05:00

How long will anxiety last? When my daughter started having anxiety and then panic, I kept hoping it would last just a few weeks...then months...then a year. I am a psychologist so I knew what was happening but as a dad my expectations were all over the place like any parent. Having your expectations way off can make this journey more excruciating than it is already.

People with anxiety are impatient. Parents get impatient because their lives and the life of their child is seriously impacted. Anxiety feels terrible and they want it gone. When you child says they want it to go away but can't help it, they mean that. (They can do things but don't know what those are.) Your child will often have no idea what is happening. You can ask them why they think they are struggling and they may not have a clue. Anxiety disorders are complicated. Here is one of anxieties tricks. The more desperate and frustrated you get the more you activate the very part of the brain you need to calm. Your child needs your calm confidence. You will need to cultivate patience.

Overall you can have hope. Anxiety is treatable. Sometimes it responds really quickly. Sometimes it lasts longer than the wait at the DMV when you're in a hurry. Sometimes it goes away and then comes back. Don't get tempted by one of anxieties favorite distortions, "This will never go away!" Yes it will but you have to treat it. If you avoid facing it then it can last a very long time. I have watched the show, Hoarders, a few times. Hoarding is a severe symptom of OCD which is an anxiety disorder. Some of those people have been doing that a long time but they have not pursued treatment. Don't judge, facing fear is way up on the Richter scale. I only mention it because you may know of examples of anxiety lasting a really long time but two of the main reasons are avoidance or just not knowing what to do. Don't get tempted to fear the future, there is hope.

Anxiety is almost always far more complicated than it seems on the surface. You cannot think of it like regular worry and fear. It is different. I'll have to save that explanation for another article. Here are 6 things to think about regarding expectations:

1. Don't expect miracles or simple solutions. They can happen, just don't expect one. Each time you crank up your hope too high and you don't get a cure, the more upset you will get. Your child can overcome this, just watch out for the hidden pressure of "miracle" cures. By all means try things, just realize that this is not a simple issue.

2. Manage your hope. Be careful to not lose hope. That can lead to depression. This stuff is stubborn but there are all kinds of ways to treat this successfully. One thing frequently impacted is sleep. That is one of the first things to address if it is out of whack. Sleep deprivation can lead to depression and impatience (plus you drift off while listening to your pat...oh wait...that's me). If something hasn't worked then keep trying. Something will work.

3. Don't wait around for a cure to drop from the sky. Learn what you can, make appointments to see professionals, get resources for your child. You and your child have been given an obstacle. Set out on the journey to find a solution. Get yourself geared up. It will take as long as it takes.

4. Don't get anxious about your child's anxiety. Don't start freaking out about the future. Yes, this will mess up your life to some extent. You can agonize over this or accept it. Things will go wrong--school, friends, you having a life.... It will be okay. Trust me, I've been there.

5. Allow for setbacks. Don't evaluate how things are going by any one day or set of days. It is up and down. Keep a record and look at the trends.

6. Do your best to minimize comments from the "audience". People will have lots of opinions about what you should do and what you are doing wrong. You have to manage who you talk to about this. You and your child are doing what you can. Keep critical people out of your expectations.

How to Help Your Anxious Child - What to Do If Your Child Resists Help

2010-02-14T18:58:00.000-05:00

Why would someone fight getting help? Seems puzzling doesn't it? What would cause a child to push back instead of jump at the chance to get free of fear? Your child may even resist talking about anxiety at times. The more you understand this the easier it is to get past your child's resistance and on to freedom.

Think of anxiety as having two parts. A kid goes to the doctor. In the waiting room are other kids who look miserable and some are crying. Then there is an exam and all of a sudden this gigantic needle is jabbed into their arm. Eeeooowww! Fight or flight RESPONSE! We will call this anxiety part one. Part one is mostly reaction not anticipation.

Fast forward to the next appointment. FEAR! Anticipation! She may not know why exactly, but with all her heart she does not want to go. We will call that anxiety part two. Part two is primarily the source of your child's resistance. Something terrible might happen! Your child has the same fight or flight response without the actual presence of danger. It trumps everything. It is safety or nothing. Your child is not being a "pill", their biology has command.

This powerful feeling can be very hard to override. Along with that, anxiety just plain feels bad. With some anxiety it doesn't need to be an upcoming shot (or whatever else), just the possibility of awful fear feelings. Sometimes this is described as fear of the fear. If you are getting resistance then your child thinks (right or wrong) that you, someone else or other circumstances are not on the same page with them about the possible danger ahead. They feel like they have to take things into their own hands. So what can you do?

1. Acknowledge their fear. "This is scary isn't it?" Reassure- "We will figure this out, you will get over this. We will do what we have to do." You won't feed it if you acknowledge it--just the opposite. Let them know you are on the same page. You are an ally and not an opponent. Opponent may seem harsh but the fear response has two boxes: safe--dangerous.

2. Fear feels out of control. Can you give them some control? Can you give them some choices? Once I helped a mom with a very shy child. Her child would get visibly upset when adults spoke to him. I told the mom to give him some choices like, "Would you like to talk to someone now or later? What if you took a few minutes and then spoke? How about you talk to 2 people today and that can be all?" It really helped. But this is important--giving control must not be permission to completely avoid.

3. Fear must be faced to be overcome. Avoidance makes it worse. It can be faced all at once or a little at a time. Convey to your child that this is the real way to make it go away. You can say, "I know it seems like avoiding the scary thing works but does it really? You get relief but is the problem better?" Take time to help them work out some steps to face it. If they agree to the steps then you are way ahead.

4. They are stronger than they think. Anxiety makes people feel that they can't take it. Say this gently but say it over and over: "You can take it, you will make it, you are stronger than you think." The thing is--they are taking it. Don't minimize their feelings, maximize their strength. Point out every time they solve a problem of any kind. Just because it is complicated doesn't mean they won't beat it.

5. Externalize the fear. Have them give their fear a silly name. Then you can problem-solve about "Mr. Willys". That helps your child see their fear differently and feel less self critical. Notice the difference between, "What can you do about Mr. Willys' sneaky attempts to scare you?" versus, "What can you do to stop being scared?"

How to Help Your Anxious Child - Parenting Strategies For Anxiety Disorders

2010-02-14T18:51:00.000-05:00

I am the father of a child who had panic attacks. I am also a psychologist. Professionally, I know how to treat anxiety but I had to figure out how to do that as a dad. Believe me it is fundamentally different. Forget professional perspective, this is my precious child! I made a lot of mistakes but I learned some things. Finding a way to parent that includes psychological understanding is key. Here are some observations from living with my two perspectives.

All anxiety disorders share the same 3 fundamental components. If you develop parenting strategies that address these three components you will be way ahead and everyone will be less frustrated.

Activation. When a child is anxious their nervous system has kicked into a fight or flight response. To put it simply-they are cranked up. Sometimes this is obvious, sometimes less so but trust me they are cranked up. It is a biological fact.
Analysis. There is something about the way life and events are being interpreted that is activating or maintaining the fear and worry. Can be hard to nail down but it is there.
Action. Anyone who is anxious is either trying to escape or trying to restore control with strategies and rituals. They are trying to get control back.

Here are some strategies based on each of these three components.

1. Activation. Just for a minute turn down the volume so you cannot hear all the reasons for the fear. Just think of the fact that your child's nervous system is cranked up. The throttle is wide open. Lots of things activate this part of the brain, not just this particular fear. Here is a fundamental parenting guideline: Don't throw fuel on the fire! If you get angry, frustrated, anxious, demanding, etc. all those can be distressing to your child so that you inadvertently ramp up the anxiety. Parent toward calming the nervous system when your child is anxious. You can be firm, just be calm. Calm tone, calm voice, calm touch, words of hope and encouragement...calm, calm, calm.

2. Analysis. Anxiety makes things seem dangerous! Dangerous thoughts captivate. Understand that these negative thoughts are surprisingly stubborn. Don't get frustrated or take their resistance personal (see previous point). Attempts to help often bounce off when anyone is cranked up. Fear and worry are fully activated simply by something being possible (it can be very unlikely). Possible is easy to imagine. Fear multiplies possibilities. Overcoming fear requires much more certainty! Problem solving is much more complicated than problem imagining. It will take time. Be patient. Also, anxiety makes you think you cannot deal with it, cannot take it. Anything, whether directly related to the fear or not, that increases their confidence that they can accomplish things and overcome obstacles will help. Build confidence and courage! Anxiety makes you think you are messed up. Not true. It is just anxiety with a stuck throttle. Once the activation is gone the issue is gone. Tell them over and over, it is just anxiety. Don't wander off into elaborate explanations of cause and effect. Simplify, don't multiply.

3. Action. Fear must be faced. It is tempting to avoid it. Don't fall for the temptation. There is no way around this. It is how it is cured. Help your child figure out how to do this. Can be all at once or bits at a time. If it is too much, break it into steps. Anxiety feels like a shattering loss of control. Cannot control thoughts, cannot control body, cannot control situation. What is this like for a child! If they feel forced into the anxiety provoking situation that will increase the feeling of loss of control. Anything you do to help them choose to face it themselves is far preferred. They must choose to face it ultimately. They will discover they are not afraid of it because choosing puts them back in control. When facing something is unavoidable try increasing the discomfort of not facing it rather than forcing them into it if possible. That still makes it their choice. Note: When anyone first faces fear it can go nuclear. No way around that. Do not let the symptoms freak you out. You have to stick with facing it a while before it starts to lose power.