The science of anger

Self-restraint can be hard to effectively manage. There's been an ongoing debate about the notion of catharthis and whether it works to help us relieve emotions or not, for example. A recent article in Wired.com discusses the issue a bit more:

My favorite experiment involved movies. Two hundred and thirty nine subjects were given a choice between a virtuous apple and a hedonistic chocolate bar. (A slim majority chose the apple.) Then, they were offered a selection of movies to watch, from Anger Management (an anger themed film) to Billy Madison (a non-anger themed film.) Interestingly, students were significantly more likely to choose the angry films if they’d first chosen the apple. And it wasn’t just films: another experiment found that people who exercised financial restraint – they chose a gift certificate for groceries over one for spa services – were more interested in looking at angry faces.

But just because practicing self-restraint can lead to some anger-related experiences, it doesn't mean that we should forgo self-restraint entirely. Over time, not succumbing to urges will weaken the power of those urges. The implication is that if we can practice self-restraint consistently, we'll be reducing how often we feel angry and/or seek out anger-related stimuli.

Thinking faster

Training the brain through mindfulness practice is an essential part of Dialectical Behavior Therapy. We work on developing a way of sorting out what is important to attend to and what needs to be left out of awareness. It’s not ignoring information, but making quick decisions about where mental energy needs to be focused.

A recent study, described in the New York Times, highlights some of the differences between athletes and non-athletes in a decision making exercise:

They didn’t move faster,’ said Art Kramer, the director of the Beckman Institute and a leader in the study of exercise and cognition, who oversaw the research. “But it looks like they thought faster.”

The author, correctly, goes on to emphasize that athletes may not be better at making quick decisions because of their athletic participation but it could be that their participation in sports and their ability to make quick decisions are related to a 3rd factor. It may also be that there is a virtuous cycle between that unnamed 3rd factor and athletics:

Of course, it’s also possible that sports didn’t make the athletes better at information processing. Instead, they may have been blessed with naturally fine processing abilities and, as a result, became accomplished athletes. “I’d guess,” Dr. Kramer said, “that to some degree it’s both.” But, he added, the athletes handled the crossings better than the nonathletes, regardless of whether their sport required exquisite timing and tactical thinking — which strongly suggests, he said, that physical training does reshape the brain.

The take-home message for all of us non-athletes is that working on mental acuity exercises and being mindful while doing activities can help improve your ability to be mindful and effective in making decisions.

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!

"You will be FAT if you eat today. Just put it off one more day." (Don't do this.)

This says it all:

”You will be FAT if you eat today. Just put it off one more day.”

This is the #1 reason on many lists on sites that promote anorexia and it's really startling. I hope by putting that as the title of my post, a Google search for it will come up with something that's not promoting an eating disorder. Right now, if you do a search for that phrase, you'll get list after list of why not to eat. As a mental health provider, I've seen these reasons echoed in the thoughts of some of my most stricken patients. It's scary to see them in writing.

If you're struggling with an eating disorder, please visit NEDA's site, at least. 

A Vogue editor is trying to stamp out “pro-ana” sites. I was shocked to learn of the existence of these sites while I worked at Carolina House. They promote the lifestyle of an eating disorder as if it were a valid choice. I don’t agree, necessarily, with the need for regulation of sites that promote eating disorders, but I do wholeheartedly agree that they need to be labeled as dangerous, unhealthy and have a very bright light cast on their existence.

When I work with patients suffering from an eating disorder, I often describe the way an eating disorder works like roaches: they both thrive in the dark. Put light on your disorder and let people who care about you know about your struggles so they can help. That's really one of the best ways to be sure you can maintain your recovery.

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.

Emotional distress and college freshman

The New York Times had an article several weeks back describing the levels of stress students face in college as being at an all-time high. Given what I'm seeing in my DBT-U, with full groups every semester and our recent addition of a second group in Durham, which is also full, I'm not surprised. The NYT reports:

“Most people probably think emotional health means, ‘Am I happy most of the time, and do I feel good about myself?’ so it probably correlates with mental health,” said Dr. Mark Reed, the psychiatrist who directs Dartmouth College’s counseling office.

“I don’t think students have an accurate sense of other people’s mental health,” he added. “There’s a lot of pressure to put on a perfect face, and people often think they’re the only ones having trouble.”

I chose this part of the article to highlight because it seems quite important to point out what many in our groups find: there are others out there who are struggling, too, and getting validation of that can be therapeutic in itself. Clearly, just having a support group isn't enough to deal more effectively with emotions - DBT skills group is much more than a support group - but it does help to know that you're not alone.

Addiction is addiction

Slate asks: Exercise and drug use: What do they have in common?

There's another, slightly more disturbing theory for why exercise helps stave off relapse—that working out helps people (and rats) resist drugs because of its similarity to those drugs. Have you ever felt irritable after skipping a yoga class or two? Or a little depressed and lethargic when you don't have time for the gym? These might be construed as withdrawal symptoms—the eventual outcome of an activity or habit that mimics, in some important ways, the effects of morphine and cigarettes and dope.

It's an interesting question. I've worked with women who have had extreme cases of exercise addiction and I've also worked with many people with substance use histories. If I were to read transcripts of our discussions with one or another of these types of clients, and the transcripts were scrubbed of the words "exercise" and "drugs", I'd be hard pressed to tell who was talking about what. The addictions are scarily similar.

Give this article a read and follow-up on some of the links therein. There is a raft of research on exercise addiction and its harmful effects on the body and the mind. As with many things, it's all in moderation.

Being an expert isn't all that great.

For a long time, psychologists have known about the heuristics people use to make sense of their worlds. One of the better known is the idea of chunking information into to smaller, more manageable pieces of information. Try memorizing this number (no cheating!):

8 2 8 4 3 2 5 7 6 1

Some of the more astute among you might notice that's a 10-digit number with an area code somewhere in the vicinity of Asheville, NC (a beautiful place to visit if you ever get a chance!). So, you're probably ahead of the game.

We memorize a new 10-digit phone number by making chunks of 3, 3, and 4. That translates into a mental load of just 3 things you need to remember rather than the 10-digits you might try to memorize. This is great for information that we're familiar with and translates into useful mechanisms for learning.

Wired describes the phenomenon in other terms:

[T]hat talent wasn’t about memory – it was about perception. The grandmasters didn’t remember the board better than amateurs. Rather, they saw the board better, instantly translating the thirty-two chess pieces into a set of meaningful patterns. They didn’t focus on the white bishop or the black pawn, but instead grouped the board into larger strategies and structures, such as the French Defense or the Reti Opening.

I'm an avid NPR listener and everyday at 9:00 AM, they have the BBC World Service's broadcast. During this program, the host often calls for feedback from listeners and announces a string of numbers that I just can't get my head around. It's because they chunk the information differently. The host announces the numbers in a series of 2 digits at a time for that same 10-digit length phone number. But my brain can't handle the different presentation.

Wired goes on to say:

The problem with our cognitive chunks is that they’re fully formed – an inflexible pattern we impose on the world – which means they tend to be resistant to sudden changes, such as a street detour in central London. They also are a practiced habit, and so we tend to rely on them even when they might not be applicable. (A chess grandmaster has to be careful about applying his chess chunks to checkers.)

So, next time you're having a hard time committing something to memory, try thinking about it as a naive person. Use what Suzuki calls Beginner's Mind.

You're not doing it right.

The New York Times has been doing a nice job of covering one of my favorite topics: mindfulness. Their latest article highlights one of my other interests: technology and its use in psychological research. The NYT reports:

Whatever people were doing, whether it was having sex or reading or shopping, they tended to be happier if they focused on the activity instead of thinking about something else. In fact, whether and where their minds wandered was a better predictor of happiness than what they were doing."

I believe that the paper's use of the generic term "happiness" (and possibly the research article summarized therein) might be oversimplifying the experience that comes when one focuses one mindfully on an activity since other research on mindfulness finds that the emotional experience is more akin to contentment than happiness, but the point remains: if you want to feel positively, focus one-mindfully. What you're doing isn't as important as how you're doing it.