Dr. B's Blog

Can Shame Be Useful? - The New York Times

How can emotions be helpful?


1) Motivating one's action: emotions make you do stuff.
2) Communication to others: they convey important information to others without having to actually tell them directly. 
3) Communication to yourself: they tell us important information about ourselves; what is important and meaningful.

 

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Modulating interpersonal intensity

In group last week (Dec. 6, 2012), we were wrapping up our discussion of the Interpersonal Effectiveness module. I left the group with the idea that there's a lot to be said about modulating intensity rather than being over-the-top assertive all the time. I have always felt that it's best to be only as assertive as you need to be - both from an effectiveness standpoint and a self-respect one. (Needless to say that the third of our 3 Interpersonal Effectiveness goals, relationship, will be best served by lower intensity.)

I recently ran across a very brief article about the effectiveness of being less assertive for New York cabbies. The nugget from this article (and I'd heard this before): cabbies got paid more by hinting at higher tips than demanding them.

Joshua Gross estimates, that this simple nudge has increased the income of taxi drivers by $144 million per year. Had the drivers demanded this increase via an increase in rates it probably never would have happened.

If it works in New York, it can work anywhere.

"You are getting sleepy... Very sleepy...."

Among the patients I've worked with over the years, sleep difficulty is easily the most common secondary complaint to their presenting problems. And it's often one that's neglected or forgotten about amongst the many other issues going on. Many clients are on sleep medication and have found some relief from them, but I came across this book which claims that:

A number of studies have shown that drugs like Ambien and Lunesta offer no significant improvement in the quality of sleep that a person gets. They give only a tiny bit more in the quantity department, too. In one study financed by the National Institutes of Health, patients taking popular prescription sleeping pills fell asleep just twelve minutes faster than those given a sugar pill, and slept for a grand total of only eleven minutes longer throughout the night.

I'm not a psychiatrist so I don't know about the science of the meds. But if it works only because you think it should, what's really wrong with that?

If You're Too Busy to Meditate, Read This

Mindfulness practice, sometimes equated with meditation, is a very big part of DBT. It helps us focus and manage our emotions more effectively. It helps us live in the moment without judgement and increases our awareness of our current experience. It helps us stay focused.

Research shows that an ability to resist urges will improve your relationships, increase your dependability, and raise your performance. If you can resist your urges, you can make better, more thoughtful decisions. You can be more intentional about what you say and how you say it. You can think about the outcome of your actions before following through on them.

Perception

I always wondered how I could constantly be surrounded by imperfect clocks and their irregular second hands. The BBC reports:

You'll be in the middle of something, and flick your eyes up to an analogue clock on the wall to see what the time is. The second hand of the clock seems to hang in space, as if you've just caught the clock in a moment of laziness. After this pause, time seems to restart and the clock ticks on as normal.

Kids and mindfulness

Jonah Lehrer, one of my favorite neuroscience writers in in the popular press writes:

Children who could better regulate their impulses and attention were four times less likely to have a criminal record, three times less likely to be addicted to drugs and half as likely to become single parents. In many instances, the ability to utilize executive control was more predictive of adult outcomes than either IQ scores or socioeconomic status.

This is an interesting perspective. While he doesn't mention mindfulness by name, it's essentially what he's talking about. Specifically, he's referring to the aspect of mindfulness that helps manage attention. Developing ability to choose where to focus your attention seems to have benefits across the lifespan.

Talk is cheap (and effective)

MSNBC reports on suicide in the Native American Community:

"Let's say that all your emotions are in a glass of water. When somebody bullies you, dump out a little bit. When somebody offers you drugs and you take those drugs, and then somebody tears you down because you used drugs, pour out a little bit. Eventually that glass of water is going to be empty and that's kind of like your self-esteem. You're going to be empty, so you're going to try to commit suicide," said A.J. Hollom, a 14-year-old student.

The thing that's so sad about adolescents killing themselves is that it's so readily preventable. Teens experience the entire range of emotion but don't have the entire repertoire of coping skills needed to handle them. There are very effective treatments for suicidal adolescents and my method chosen method of treatment, Dialectical Behavior Therapy, is one of them.

For parents, therapists or concerned others, I recommend Dialectical Behavior Therapy for Suicidal Adolescents. I have spoken to the authors and listened to them give lectures and it's a great resource. The book is targeted at clinicians, but it's important for caregivers to be informed, too. If you've got other suggestions for books or resources, please mention them in the comments!

Stimulating Happiness

Paul Krugman, a nobel laureate, knows what he’s talking about when it comes to economic theory. There’s very little doubt that he’s a well-respected expert on economics and has a very specific stance with respect to government’s role in the economy. He recently discussed the impact of jobs on happiness:

So are Americans happier? Of course not — in 1999 or 2000 everyone could easily find a job, right now everyone — even the highly educated — faces the prospect of very long-term unemployment if anything goes wrong.

He makes an accurate connection between employment status and jobs and discounts the importance of income as a factor in happiness. On the surface, we may believe that mo’ money, mo’ happiness, but we know that’s not true.

Mo’ money, Mo’ problems

I wish he had backed up his assertion that people are unhappier now than they were during the end of the last decade. Our general sense is that there is some emotional malaise throughout the country, if not the world, but I’ve not seen any specific data to support that assumption. Be that as it may, working is clearly important to one’s well-being. But you don’t need to get paid to get the benefit. If you’re having trouble finding a job or meaning in your work, think about volunteering. Volunteer Match is a fantastic resource for volunteer opportunities. Type in your zip code and it’ll give you a number of options.

Bipolar disorder vastly undertreated

Reuters reports on an issue that has been troubling me for some time: the under-treatment of serious mental health conditions. Along with schizophrenia, bipolar disorder is responsible for a phenomenon called downward social drift that we see occur as a result of major mental illness.

Bipolar disorder is responsible for the loss of more disability-adjusted life-years than all forms of cancer or major neurologic conditions such as epilepsy and Alzheimer's disease, primarily because of its early onset and chronicity across the life span," Kathleen Merikangas of the National Institute of Mental Health and colleagues wrote in the Archives of General Psychiatry.

I think the Affordable Care Act will help in this respect since we may be able to see a time when one's health insurance isn't tied to being employed at a place that offers benefits. It would be very difficult for someone with a condition like bipolar disorder or schizophrenia left under/untreated to hold a full-time job long enough to get benefits. It happens far too frequently and with the mental illness untreated, the likelihood of holding a job with benefits decreased. It's an awful cycle and one that does not end well for anyone - the sufferer or society at large.

Ψ Bad research or poor journalism?

Welcome to the Wall of Shame, Yorkshire Evening Post. You are the inaugural post. You nailed it so well that I created this award just for you. In one article, you did everything right/wrong.

  • Sensational headline? Check.
  • Unsourced “research”? Check.
  • Picking on a highly stigmatized group? Check.
  • Cherry picking what’s likely a small paragraph in the discussion section and making it the focus of your article? Check.

It’s articles like this one that made me really start this blog. The title of the article reads “Internet surfers caught in a web of depression.” Oh my god! The carnage and brutality we have inflicted upon our fellow man!

And the opening sentence is even better

A “dark side” to the internet suggests a strong link between time spent surfing the web and depression

I’ve got several problems with this article but the first has to do with the lack of citations. How am I supposed to determine whether the research methodology was sound without a link to the original article? I suppose I can’t with this

Source: n/a

at the bottom of the page. I’d like to believe that research conducted on the internet can be valid (I did my dissertation by collecting data online, after all). In other words, I know how hard it is to get a valid sample on the web.

But, let’s assume that they’ve got a valid sample. The article above pulls out one particular juicy tidbit from the research

Her team identified a small group of 18 hard-core internet users who spent many hours online each day and were classed as “internet addicted”.

Their average depression score was more than five times higher than that of non-addicted users, and they were more likely to be moderately or severely depressed.

Wait. They found a (very small - 1.2%) sub-sample that was more depressed than the rest of their sample? Wow! What groundbreaking research! (That’s sarcasm in case the keyboard didn’t convey the message.) They had a reasonably large sample size and then they try to draw conclusions from 18 participants? That type of work wouldn’t have garnered a passing grade in my graduate school research design class and I wouldn’t even consider submitting a poster to a conference with a sample that size.

Here’s the thing: these findings may be legitimate. We know that spending too much time doing anything that’s not social can contribute to social isolation. (Please read that sentence again. See what I did there? I can do this “research” stuff too!) And that social isolation is correlated with depression. But to put this type of information in a mainstream media outlet? I don’t know if it’s necessarily bad research but I know that’s just irresponsible journalism.